Any personal data collected here will be held securely used in accordance with the provisions set out in the Data Protection Act 2018.
Please complete this form and submit it alongside your application form.
Please complete this form in type or in black ink. If there is insufficient space for
your information continue on a separate sheet of paper.
This form consists of three sections. Please read the guidance below carefully before completing this form.
Section A asks questions relating to your right to work in the UK, previous criminal convictions and employment history. This information will not usually be shared with the selection panel prior to any decision about appointment, but may be shared at the point at which an offer of employment is made. This section is mandatory.
Section B is our Equal Opportunities Monitoring Form. The University of Sussex is committed to equality of opportunity and will consider applications solely on the basis of merit and the ability to do the job. It will assist the University to support and encourage under-represented groups and promote diversity. This information will not be shared with the selection panel.
If you are successful in being appointed for the post, this information will form part of your personnel record and will be provided to the Higher Education Statistics Agency (HESA) which is the central source for the collection and dissemination of statistics about publically funded UK Higher Education. This section is optional.
Section C relates to disability equality. As part of the University’s commitment to supporting disabled people in the recruitment process, we offer an interview to anyone with a disability who meets the minimum essential criteria as set out in the Person Specification for the job. The Equality Act defines a disabled person as someone who has a physical or mental impairment which has a substantial and adverse long-term eddect on his or her ability to carry out normal day to day activities. The information provided in this section will not be shared with the selection panel unless you indicate ‘yes’ in (b) and you meet the essential criteria for the job but have not been shortlisted for interview.
If you are successful in being invited for interview you will be given the opportunity to discuss any specific requirements you might have in relation to your disability. This section is optional.
Please note that this information won’t automatically be shared with Occupational Health if you are appointed. Instead, if successful, you will be asked to complete an Occupational Health form.
If you have any queries about any of the sections of this form, please contact Human Resources on 01273 877769 or at human.resources@sussex.ac.uk
. For office use onlyCANDIDATE NUMBER
Application for the post of:
Section BEqual opportunities monitoring form
Please complete the sections below by circling the categories or ticking the boxes where appropriate.
Postcode where you live now
Have you a disability that is covered by the Equality Act 2010?
When answering this question please note that under the Equality Act 2010 you are considered to be disabled if you have a mental or physical impairment which has a substantial and long term adverse effect upon your ability to carry out normal day to day activities.
If Yes what is your impairment? Please tick any of the following that apply:
Specific learning disability, eg dyslexia, dyspraxia
General learning disability eg Downs syndrome
A social/communication impairment such as Asperger's syndrome/other autistic spectrum disorder
Long-standing illness or health condition eg cancer, HIV, diabetes, chronic heart disease, epilepsy
Mental health condition eg depression, schizophrenia or anxiety disorder
Physical impairment or mobility issues, such as difficulty using arms or using a wheelchair
Deaf / serious hearing impairment
Blind / serious visual impairment uncorrected by glasses
A disability, impairment or medical condition that is not listed above
Please note that ethnic background is not about nationality, place of birth or citizenship. It is about colour and broad ethnic grouping. People may belong to any of the groups listed below. Please tick any of these that apply.
White and Black Caribbean
Section CFURTHERING DISABILITY EQUALITY AT THE UNIVERSITY
Using the definition above do you consider yourself to have a disability?
Would you like to be considered under the University’s policy to offer an interview to anyone with a disability who meets the essential criteria for the job?
HR use only - Please complete if candidate has asked to be considered under the University’s policy to offer an interview to anyone with a disability who meets the essential criteria for the job.
Met the essential criteria