Community Care Assistant – Equal Opportunities (EO) Monitoring Form

CCA 5 - Equal Opportunities Monitoring

MCare NI is committed to equality of opportunity for all staff and applicants.  MCare NI selects those suitable for employment and advancement solely on the basis of merit and is also monitoring its activities to ensure that its equal opportunity policy is effectively implemented.  Section 75 of the Northern Ireland Act 1998 requires us to promote equality of opportunity on the basis of all nine categories.  To assist in this monitoring process it is necessary to process it is necessary to ask you a number of questions.  


Access to this information will be strictly controlled.  Monitoring will involve the use of statistical summaries of information in which the identifies of individuals will not appear.  Whilst the MCare NI will treat the information given on this monitoring form as confidential.  Applicants are advised that legal processes may MCare NI to disclose the information given to certain statutory bodies, and, in some circumstances, open Tribunal.  Applicants should complete the form in the knowledge that it will be processed in line with the requirements of the Data Protection Act 1998. 

First name
Community Background

To demonstrate our commitment to equality of opportunity in employment we need to monitor the community background of applicants and employees, as required by the Fair Employment and Treatment (NI) Order 1998. We therefore ask you to indicate your community background by ticking the appropriate box below. Please note that it is an offence under the Fair Employment and Treatment (NI) Order 1998 to give false information to MCare NI.

Caring Responsibilities
Do you have caring responsibilities for any of the above (Tick each box that applies to your circumstances)
The Disability Discrimination Act 1995 defines disability as a physical or mental impairment which has a substantial and long-term effect on a person's ability to carry out normal day-to-day activities.  “Normal day-to-day activities" listed in the Act are mobility; manual dexterity; physical co-ordination; continence; ability to lift, carry or otherwise move everyday objects; speech, hearing or eyesight; memory or ability to concentrate, learn or understand; or perception of the risk of physical danger (If you take medication, treatment or have a prosthesis to manage your condition, would you consider that you had a disability if you were without    these? If so, you should answer ‘yes’ below).
Having read this definition, do you consider yourself as having a disability?
My sexual orientation is towards someone:
Please tick the appropriate box to indicate your political opinion
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