PHANTOM SG LIMITED

Equal Opportunities Monitoring Form

STRICTLY PRIVATE AND CONFIDENTIAL

It is the intention of PHANTOM SG LIMITED to provide Equal Opportunities for everyone, regardless of race, gender, marital status or disability. Please help us to monitor our selection procedure by ticking the appropriate boxes below. The information that you provide will be treated in the strictest confidence and the monitoring form will be kept separate from your application form. It has no part in the selection process.

1) Ethnic Origin * to which ethnic group would you say you belong? Please tick one box.

White

Pakistani

Other

Please Specify:

Black African

Indian

Black Caribbean

Chinese

Bangladeshi

Black Other

*These categories are approved by the Commission for Racial Equality

2) Gender and Marital Status. Are you?

Male

Single

Married

Female

Other

3) Do you have a disability?

YES

NO

4) Are you registered disabled?

Registered Disable

Not Registered Disable

Registered No:

If yes, what is the nature of your disability?

Candidate Details:

Full Name:

Post Applied For:

Date