EQUAL OPPORTUNITIES MONITORING FORM

Please copy and paste this EQUAL OPPORTUNITIES MONITORING FORM into your application. 

Prosimy o skopiowanie i wklejenie tego FORMULARZA RÓWNYCH MOŻLIWOŚCI do Twojej aplikacji 

EQUAL OPPORTUNITIES MONITORING FORM

CONFIDENTIAL

This information is used solely for monitoring purposes and will be kept in the strictest confidence.  You are not obliged to fill in this form, but it will assist us if you do so. Please complete this form and return it with your application for Post-Industrial Revolution residency.

1. Where did you hear about this opportunity?

2. Are you?

• Female
• Male

3. What is your age?

• under 16
• 16-19 yrs
• 20-24 yrs
• 25-34 yrs
• 35-44 yrs
• 45-54 yrs
• 55-64 yrs
• 65-74 yrs
• 75+ yrs

4. How would you describe your ethnic origin? 

·        White Polish

·        Any other White background

·        Any other background

·        Prefer not to say

5. Do you have a disability or long standing health condition?

• Yes
• No

6. Are you?

• Working full time
• Working part time
• Looking after family/home
• Self-employed
• Unemployed
• Studying
• Retried
• Prefer not to say