Recruitment Monitoring Form - Wave Leisure

Job Number: ………………….
Application Number: …………
For use by HR only
RECRUITMENT MONITORING FORM
Wave Leisure is committed to equal opportunities in employment and in order to ensure the
continued development of this policy all applicants are asked to complete the information
below. You are not obliged to answer all questions but the more information you supply the
more effective our monitoring will be. If you choose not to answer questions it will not affect
your application.
The information given on the recruitment monitoring form will be separated from the
application form prior to short listing to ensure that only your abilities, experience and
qualifications are considered.
POST APPLIED FOR: ……………………………………………...........
Name: ……………………………………………………………………….
□ Female
GENDER:
□ Male
AGE GROUP:
□ 16 – 18
□ 19 – 25
□ 26 – 35
□ 36 – 45
□ 46 – 55
□ 55+
ETHNIC GROUP:
Chose ONE section
from A to E, then tick
the appropriate box to
indicate your cultural
background.
A. White □ British
□ Irish
□ Other White background, please write in:
B. Mixed □ White and Black Caribbean
□ White and Black African
□ White and Asian
□ Any other Mixed background, please write in:
C. Asian or □ Indian
Asian British
□ Pakistani
□ Bangladeshi
□ Any other Asian background, please write in:

D. Black or □ Caribbean
Black British
E. Chinese or □ Chinese
□ African
□ Any other Black background, please write in:
Other ethnic
Group
□ Any other, please write in:
I CONSIDER MYSELF
TO HAVE A
DISABILITY:
DO YOU HAVE A
DISABILITY AS
DEFINED IN THE
DDA 1995
□ Yes
□ No
□ Yes
□ No
If yes please give us brief details below of the effects of your
disability on your day to day activities and any other information you
feel would help us to accommodate your needs and thus meet our
obligations under the DDA 1995.
CRIMINAL
CONVICTIONS
Do you have any unspent convictions which fall under the
Rehabilitation of Offenders Act 1974
□ Yes
□ No
If yes please provide details.
Are you subject to pending criminal prosecution of proceedings
□ Yes
□ No
If yes please provide details.
WHERE DID YOU
SEE THE VACANCY
ADVERTISED
□ Website
□ Friday Ad
□ Evening Argus
□ Wave Leisure notice board in Centre
□ Wave Leisure notice board in Sutton Road
□ Job Centre
□ Other (please specify)
DECLARATION
I certify that the information given on this form is correct to the best of my knowledge.
Signed: …………………………………………… Date: ………………………………..