Equalities Monitoring Form Equalities Monitoring Form Full Name of Applicant(Required) Memberhip Number(Required) Age 18-29 30-39 40-49 50-59 60-69 70+ Ethnic background – I would describe myself as White British White Irish Other White background Mixed – White/Black Caribbean Mixed – White/Black African Mixed – White/Asian Mixed – Other Chinese or other ethnic group Asian or Asian British – Indian Asian or Asian British – Pakistani Asian or Asian British – Bangladeshi Other Asian background Black or Black British – Caribbean Black or Black British – African Other Black background Other Sex – there are questions below on gender identity Male Female Prefer not to say Gender identity – Is the gender you identity with the same as your sex registered at birth? Yes No Prefer not to say If no, please write in gender identity Sexual Orientation Bisexual Gay man Gay woman/lesbian Heterosexual/straight Prefer not to say Other Do you consider yourself to have a disability? Yes No Prefer not to say If yes, what additional support, if any, do you require?Current Employment Status Full time Part time Unemployed Retired Student Experience of public office Town or parish District or county Unitary National or Europe Devolved body Metro Mayor Police & Crime Commissioner None of the above Experience of candidature Town or parish District or county Unitary National or Europe Devolved body Metro Mayor Police & Crime Commissioner None of the above The information provided on this form will be treated in the strictest confidence, and will not be seen by anyone within the organisation outside of the Governance and Legal Unit. Any information provided will be used for monitoring purposes, statistical analysis, including analysis in relation to diversity in candidate recruitment. No data will be published or used in a way that allows an individual to be identified. All data will be held securely on Labour Party servers and in accordance with the Labour Party’s Privacy Policy.CAPTCHA