Tel: 01442 869550

Equal Opportunities Form

Thank you for your job application which has been received. 

Please now complete the following Equal Opportunities form.

Should you have any questions please contact

To help us monitor our performance against our Equal Opportunities Policy, please complete this form. The information will be treated confidentially and will be used solely for the purpose of monitoring our Equal Opportunities Policy – this information will not form any part of our interview or appointment decision process.

We are an Equal Opportunities employer. Our aim is to ensure that no job applicant receives less favourable treatment than other applicants because of a protected characteristic.




Do you consider yourself to have a disability which has lasted or is likely to last at least 12 months?


Ethnic origin - I would consider myself to be: (Please choose ONE from sections A to E)

A - White

B - Mixed

C - Asian or Asian British

D - Black or Black British


Sex, Sexual Orientation, Marital Status, Religion & Age


What is your sexual orientation?

Marital Status



Data Protection: The Hospice of St Francis will process your personal data solely for the purpose of communicating with you about your application.

The information contained on this form will be kept strictly confidential.  It may, however, be necessary to divulge the information to a third party.  This will only be to accommodate your application and to seek advice or examine what reasonable adjustments it may be necessary to make.

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