Equal Opportunities Monitoring Form
This monitoring form will help us to identify any groups of people that are under-represented by Pollok
Credit Union and give us an idea of where further work may be needed in the future. Forms are
anonymous and confidential. Completion of each section is essential (please complete each section)
Please tick the relevant box in each of the sections below.
Section 1: Postcode
Section 2: Gender – are you
Female Male
Section 3: Age
Section 4: Ethnic Group (background or culture) – are you:
White Scottish
Other (South) Asian
Other White British
Chinese
White Irish
Caribbean
Other White
African
Indian
Black Scottish and other Black
Pakistani
Mixed
Bangladeshi
Other
Section 4: Disability – do you consider yourself to have
No disability or
impairment
A sensory impairment A learning disability
A physical impairment A mental health condition Any other disability
or impairment
Note: The disability categories used are broadly based on the definition of a disabled person in the
Disability Discrimination Act 1995 as “someone with a physical or mental impairment which has a
substantial or long term effect upon his/her ability to carry out normal day to day activities”.
THANKS FOR YOUR CO-OPERATION
Member
No.
Processed
by:
Resume Templates 1210 Document(s)
