Registrations

    Equal Opportunities & Diversity Monitoring Form


    Starfish Search Limited is committed to equality and diversity. We want to do everything we can to encourage talent from all backgrounds to consider applying for our appointments and go on to succeed. We are committed to
    ensuring our recruitment practices are barrier free. Please let us know if you need any adjustments or changes to be made during the recruitment process because of a disability or long-term health condition.


    The following information is collated for monitoring purposes only and is not used in selection of longlists or shortlists within the recruitment process; if you do not wish to provide the data in this form it will not cause any
    detriment to your application.

    Gender

    ManWomanIntersexNon-binaryPrefer not to sayIf you prefer to use your own term

    Age

    16 – 2425–3435-4445–5455–6465+Prefer not to say

    Disability


    The Disability Discrimination Act as incorporated in Equality Act 2010 defines a person as disabled if they have a physical or mental impairment which has substantial and long term (i.e. has lasted or is expected to last at
    least 12 months) adverse effect on their ability to carry out normal day to day activities.

    Do you consider yourself to be a disabled person?

    YesNoPrefer not to say

    Ethnic Origin

    Ethnic origin is about nationality, place of birth or citizenship. It is about the group to which you belong. Please tick the appropriate box

    Asian / Asian BritishBlack / Black BritishMixed Multiple Ethnic groupsWhiteOther

    IndianPakistaniBangladeshiChinesePrefer not to sayAny other Asian background

    Prefer not to sayAny other ethnic background

    Sexual Orientation

    BisexualGay ManGay WomanHeterosexualPrefer not to say

    Religion or belief

    No religionBuddhistChristianHinduJewishMuslimSikhPrefer not to sayOther

    Caring Responsibilities: Do you have caring responsibilities?

    YesNo

    Marital / Civil Partnership Status

    MarriedCivil PartnershipSingleI’d prefer not to sayOther

    Starfish is committed to progressing first-time non-executives. If you are applying for a non-executive / trustee appointment, will this be your first appointment of this nature?

    YesNoN/A


    Starfish Search Limited is required to meet the aims and commitments set out in its equality and diversity policy, which reflects current legislation and supports best practice. This includes not discriminating under the
    Equality Act 2010 and building an accurate picture of the workforce in encouraging equality and diversity. We use this information to review our compliance with all equal opportunities policies in relation to recruitment.


    We treat all personal information in line with current data protection legislation and our own data protection policy. For more information on how we use the data you have provided, please see our privacy policy for job
    applicants which you can find on our website at www.starfishsearch.com


    In order for us to process this information, and to comply with data protection legislation, we require your consent. You are notrequired to give your consent; you acknowledge that any consent given is
    freely given. Your job application is notdependent on your giving consent to our processing of this data. Including your signature below signifies your consent to our processing of this information. Once
    you have given consent, you may withdraw it at any time by contacting info@starfishsearch.com

    Signature:

    Date:

    Thank you for applying