Reference

R DIOFGEM DIVERSITY QUESTIONNAIRE Applicant Number

Ofgem is an equal opportunities employer and we want to ensure that all applicants are treated fairly. To enable us
to monitor the effectiveness of our diversity policies, please answer the questions below. This form is separated
from the main application form and will not be provided to the short-listing panel. Your answers will be treated in
the strictest confidence and the information you provide will only be used for monitoring purposes. How you
complete this form has no connection to the evaluation of your application in any way.

Surname:       Forenames:      

Male Transgender
Date of Birth:       Gender:
Female

What is your ethnic group? Please choose one selection from (a) to (e) and then tick
ABOUT YOU.
the appropriate box to indicate your cultural background.

British or Mixed British

English
Irish
(a) White
Scottish
Welsh
Other. Please specify:      

White and black Caribbean

White and black African
(b) Mixed
White and Asian
Other. Please specify:      

Indian
Pakistani
(c) Asian or Asian British
Bangladeshi
Other. Please specify:      

Caribbean
(d) Black or Black British African
Other. Please specify:      

Chinese
(e) Chinese or Other
Other. Please specify:      

ABOUT YOU. Do you consider yourself disabled under the 1995 Disability Discrimination Act?

Yes No

ABOUT YOU How would you describe your sexuality? – Optional. Please tick one box only.
Heterosexual Gay
Bisexual Lesbian

ABOUT YOU What is your faith / religion / belief? – Optional. Please tick one box only.
Agnostic Humanist
Atheist Jewish
Buddhist Muslim
Christian Sikh
Hindu Other. Please specify