ࡱ> cebq`  bjbjqPqP 3:::&l l l l l l l  8<t *j$p,,, ')))))))$z+h-|)l   )l l ,,) l ,l ,) ) :&,l l &, <)IX& ')0*& ^. ^.&&^.l &/ t#///))* ///*     $   l l l l l l  Camden BME Alliance Equal Opportunities Monitoring Form Please note: This is a confidential monitoring form that will be separated from the application form upon receipt of the application form Post: Director I would describe my race or ethnic origin as Asian or Asian BritishBlack or Black BritishMixed FORMCHECKBOX  Asian Bangladeshi  FORMCHECKBOX  Asian Indian  FORMCHECKBOX  Asian Pakistani  FORMCHECKBOX  Asian Chinese  FORMCHECKBOX  Other Asian please specify FORMCHECKBOX  Black Caribbean  FORMCHECKBOX  Black African  FORMCHECKBOX  Black UK  FORMCHECKBOX  Black other: please specify FORMCHECKBOX  White and Black Caribbean  FORMCHECKBOX  White and Black African  FORMCHECKBOX  White and Asian  FORMCHECKBOX  Other mixed: Please specifyWhiteOther Ethnic Groups FORMCHECKBOX  White UK  FORMCHECKBOX  White Irish  FORMCHECKBOX  White other please specify FORMCHECKBOX  Chinese  FORMCHECKBOX  Other: Please specifyPlease specify My gender is  FORMCHECKBOX  Female FORMCHECKBOX  Male My age is between 16 65  FORMCHECKBOX  Yes FORMCHECKBOX  No I have a disability that I would like Camden BME Alliance to know about  FORMCHECKBOX  Yes FORMCHECKBOX  No Please state where you saw this job advertised:     Camden BME Alliance Background Information  FILENAME EthnicPage  PAGE 2 of  NUMPAGES 1   FILENAME EthnicPage  PAGE 1 of  NUMPAGES 1 8    / 0 5 6 7 8 F G H [ \ j k l z { 񻴦~l~~Z~~#jhhCJUaJ#jhh\4CJUaJhhCJaJjhhCJUaJhhIn5CJ\aJhh5CJ\aJ h`h` hInhInhFhF5\ hF5\hF5CJ\h\45CJ\hInhIn5CJ\hInh\4 h7n5hC"89F  0 6 $$If^a$gdl$gd\4$ ^a$gdIn$a$gdF$a$gd\4$a$gdIngd\4 & 6 7 [ z + F t  ~~~~~~~~~~~~~$$If^a$gdl$fkd$$IflF #   t6    44 la    + , : ; < F G U V W t u ӯӧӕӃq_#j:hhCJUaJ#jhhCJUaJ#jRhhCJUaJ#jhhCJUaJhCJaJ#jjhhCJUaJ#jhhCJUaJhhCJaJjhhCJUaJ#jhhCJUaJ%   ! ( 6 7 8 F G H R S a b c p q  ӯӝәn\#j&hhCJUaJ#jhhCJUaJh\45CJ\aJhh5CJ\aJh#j hhCJUaJ#jhhCJUaJ#j"hhCJUaJhhCJaJjhhCJUaJ#jhhCJUaJ#  ! 5 6 ~~~$$If^a$gdl$fkd~$$IflF #   t6    44 la6 7 R p ~~~~~~$$If^a$gdl$fkd$$IflF #   t6    44 la          ) ӹӧӣ~z~zkYkk#j8 hh\4CJUaJjhh\4CJUaJhIn hhIn hhh\4hh\4CJaJh\4CJaJh#j hhCJUaJ#j hhCJUaJhCJaJhhCJaJjhhCJUaJ#jhhCJUaJ! ~~~$$If^a$gdl$fkd $$IflF #   t6    44 la   1 2 ttt$$If^a$gd\4l$gd\4gdfkd $$IflF #    t6    44 la) * + , 0 3 4 N O ] ^ _ ` c d e s t u v x { | ! % & ӮӜӖӄrӖk hh #jhh\4CJUaJ#j<hh\4CJUaJ hInCJ#j. hh\4CJUaJ#j hh\4CJUaJh\4 h\4h\4h\4CJaJhh\4CJaJjhh\4CJUaJ#j hh\4CJUaJ)2 3 4 N d y z ttt$$If^a$gd\4l$gd\4gd\4fkd $$IflF #   t6    44 laz { | ttt$$If^a$gd\4l$gd\4gdInfkd $$IflF #   t6    44 la " # {:@kd$$Ifl#F$ t644 la$@&Ifgd\4l$^gd\4fkd$$$IflF #   t6    44 la# $ % & ( ) + , . / 1 2 ] $Ifgd gd\4@kd:$$Ifl#F$ t644 la$$If^a$gd\4l$ & ' ) * , - / 0 2 ] ^ ` a b c d n o u v w | } h2JE0J]mHnHujhInUhh\40J]mHnHuhd>hIn0J]jhd>hIn0JU]hd>hIn]h\4mHnHujhd>hInU hInCJh hd>hIn hIn6hInh bjh bU3] ^ _ ` a b c w JQkd$$Ifl0### t644 la $$Ifa$gd $Ifgd  $^a$gd7n5@kd$$Ifl# t644 la $$Ifa$ $Ifgdd>$a$gd7n5Qkdu$$Ifl0### t644 la E<:^gd Skd6$$Ifl0#   t644 la $$Ifa$ $Ifgdd>Skd 6$$Ifl0#   t644 la ü hh h bhIn hInCJhhd>hIn]h\40J]mHnHuhd>hIn0J]jhd>hIn0JU] gd\41 0:p . A!"#S$S% $$If!vh5 5 5 #v #v :Vl t065 5 tDeCheck1tDeCheck1tDeCheck1tDeCheck1tDeCheck1tDeCheck1tDeCheck1tDeCheck1tDeCheck1tDeCheck1tDeCheck1tDeCheck1tDeCheck1$$If!vh5 5 5 #v #v :Vl t065 5 $$If!vh5 5 5 #v #v :Vl t065 5 tDeCheck1tDeCheck1tDeCheck1tDeCheck1tDeCheck1$$If!vh5 5 5 #v #v :Vl t065 5 $$If!vh5 5 5 #v #v :Vl t065 5 / tDeCheck1tDeCheck1$$If!vh5 5 5 #v #v :Vl t065 5 tDeCheck1tDeCheck1$$If!vh5 5 5 #v #v :Vl t065 5 tDeCheck1tDeCheck1$$If!vh5 5 5 #v #v :Vl t065 5 z$$If!vh5F$#vF$:Vl t065F$$$If!vh5F$#vF$:Vl t065F$/ U$$If!vh5F$#vF$:V l t65/ X$$If!vh5#5##v#:V l t65#/ X$$If!vh5#5##v#:V l t65#/ Q$DdC  C `AHcamden%20bme%20logo%20full%20colourby#Wp` SͥU# nM#Wp` SͥPNG  IHDR(DBhsRGBgAMA a cHRMz&u0`:pQ< pHYs55 !Cw"IDATx^m,9nDUV7ފО;㚩Lg?!2RY_@@@` ˽v?p5_Oѯ'%Kk;p^qI8"PAztQW< 8q+Nv{>Moԉ:8 Py@Ypȑ%B 8q+P(A;OsWx∮YVO}~bq,yÆgr :@G֫k;Ylfd3 €W8_8\3kgH o"" Q;F~Q߫k ͑ @3 ѽ}3kFEb^;yY[߳k(g^SW@ O.XCAOgQq3&[#D op4HQ12:,_ye+W 6"f5+^(ML`/op DJe#qD 7ٟXfn"XϮ]Uw(ޞhP(ߣkG^Pb'UZޞ P43ޢs&Ya ={"8f$&> RxkpMMY]ٷ}G֧f~ g8q 2F־@tٛ07C$D1~_?ۓ+f!QcwϷ^F290:Xf̡avja~#fA29  ofКٛq2?j2oy|3op` 3g&ۓ耞kSY1@&;v/8q8h`fp8j9@U 0_8q P(|pl+~f6Ch4 p.@< 8 (mEs p` "$O隚 ޜf*||w4~MQ("%j@9\dUU.|YӯQk@9@I@yV@ P@:^=\wGĆ%FoC1x\rdoiT"(=oRG]Dd~Šm̶g? P?閆R3\\g94j߻kǛW^ԏaqC}[ѸXDHM"#kX">XD}WG PRJ8(niFs gperooZ5 "]5'kzp`_DH><=qxx?@E%<̈́59jo"tXVڋ^{0O/\<̈́59jo1Z}z+ J^DH}(јX vn'>W9->G|[*?x|W0l0L*׋Am^s"k= P( !an͈KDz#vE|{hͬ(a=;p :H`ղ5*.᤺P|Fs,8t>2Uފf@IA5gK}39vUkݓ$*{*zB$Nu[oaY %Y`qTr 2G>xX$+mL4OY P(C80 ؏8'!ڨ/k=}#q\i&F2dgp@qߠ P84o@ PTAqKá!F;p 18D P(.y!$gpJnP|zA(\:uQyY$?sXȪ8UŚݸZ(۟sjpݏg^;W ~mpPT Nun{;[gx@0~ϲSS 39c*,?#9*d5 ; #6UP%T~,?l){Ua'jQyQ§θ0v3Ja2gw@ ^ފ]C)f4;X<ĖUUЊFYu'J|m{Y9}q7##<-(G\{G*?wyU+o+֍ʩې6ۦC7̿s;ǞT*Pv9r ٵA(5nsu|UPl5^Gl٫ ?A+{Ş~ wqV`UapՐ@?SEC ̪mW6S܃mP8On;W@IU9 7:TSb(9bs ޞ83kߞX7O( 7(;UO('TւAU9?eBT6"|v0TO=jk3y/Z(hfp@QBS U7}W Ζ}e_y(IEIF/U8n[U[ĉA#P|8vnl7l"P(ނ{שʏ7]]u[*_%|vxU?/<( E݄įliV5'U'mXuu|s'n`lPt'oUsv *&]uΪr{F.q$;Dרrb|;qR!p1ɩU{?G P𫚾*JjTesr(G?JPxIe>]6?ܞt S֘s?w`;w/WBDI6'?Бvjj*!Qew%V;> qmۓ8`*ScuנY~>i/oqAi*B"U.!9\ik_q8Wkyo%PrW<]*޲O>ʴ_Vū[EPcAVJfUZqh>ȥ6YUWۭ:g;jWMoPfl"dUC -{ƱW7(ZUvOEfn_=U5*O>Ga+W5say>Uv-zƎN !|)*p*;ڭ8gՎȌyǾSC:LeR67l?U0CW\s1=U(kÎ3 ,;!(|U5N=&3WUNοsq'<Ēc)#UCjh bC_0Tnw}yb53tޫl*_eDtLlJ̯pUiWJDT]eWR unƩQ&_ԶQeWϮ@4]5 _R?kFjjqQڱ x{_,P"<9)ʗpUrUOMO]*1cͪQewGWL qr _q8Ռ8~+ϙOdq=j (u״VAi &8J,_VjV<+8٘p˲3n#OeD+㍀쪜sɶQN6Tu}L=@:侹y+A(U(Z8*;Ẹxfq5#UU#5(^rjӯ8HQBwlU1*TvUUQV 8eeН|wi٘(3D =kw<Ѡ=~ {^YgUA?B}`q !͕݌|Ux<1U?ī>#X!P_t'oA#5M@w4Wqb7c5_VsE_{$N{Fk@A o%Au((D3bQU/#jR1r_bP)]}@+&Tն®%N<~4.j1ֈGSmO,(\. @)AmZ;cR0|۟=;;/+DPfj[3<^x~eQ D\KHNzZ/)V֣RwUC_+:SX"¹k4o jƩ[Q?婊CJ?zd[=[sTm㱱bj4@ $(yC]C5XT|ㆇNU9r+|T᮲@񼀎3SkԦ'ͪX9'!qtgl$;-h\[u޸E}r]/zz9/LߖHl;Cf2!h jnԧw(J8(reoy4\rP_+whXĠy~7{E\#qd.o.%z2sPg@M|| v'onO(+(?1⪷wfcbPpՊs9`?UWY\"1R W^%gbىZkGOq*|dmK<~&֞'=?EpH R8cE\Plۙ<@țFyr)Q>e]|Ua9jw5.!aCW4e?|SUdUv,{m',n}vp6H ph9@App()yKѾ7x8Б??88@Ahp8pF8 9@Qp< p8Ўzb$ޚphp8@CPEA9Op@ɟ&8(Fp8АaQPμ=89@A88.+F 8p4EiX3oOp8t P(p8@; 銑ykp8bD883Footer 9r ^ 6CJhD>@D l@Title$d,1$a$5CJaJhdS@"d Body Text Indent 30d,1$^`0 htH udR@2d Body Text Indent 2hd,1$^h` htH u<B@B< Body Text$ ha$^C@R^ Body Text Indent$d,1$^a$ htH uV^@bV g Normal (Web)$dd^a$ CJOJQJ.)@q. Page NumberXOX Heading 2 Char$5OJQJ\_HhmH sH tH uJOJ Quote$ nn^na$6]^JtH FoF Bullet  & F ^`<P@< \h Body Text 2 dx6U@6  Hyperlink >*B*ph@ In Table Grid7:V0$S<<^Sa$:89F067[z +Ft!567Rp1234Ndyz{|"#$%&()+,./12]^_`abcw0000000000 0 0 0 00000 0000 0000 0 0 0 0 0 000 00 0 0 0 0 0 0 000 0 0 0 0004 04 04 04 0400| 0| 0| 0| 0|0| 0| 0| 0| 000000000000000000000@00@0 @0 @0 @0 0 @0 @000 ::vy  ) &  6  6 2 z # ]   7G[kz +;FVt7GRbp*N^dtG$G$G$G$G$G$G$G$G$G$G$G$G$G$G$G$G$G$G$G$G$G$G$G$=HOV]_doq|!!8@0(  B S  ?Check18Hx t #ll  ^a $L7l $Ox Dp ܯ CCOO2==      EEQQ8EE B *urn:schemas-microsoft-com:office:smarttagscountry-region8*urn:schemas-microsoft-com:office:smarttagsCity9 *urn:schemas-microsoft-com:office:smarttagsplace 0   %&&(())+,./12cv|&&(())+,./12[Ft7p|%&&(())+,./12c|%&&(()*+-.012cv| (4 Z h^`OJQJo(hHh^`OJQJ^Jo(hHohpp^p`OJQJo(hHh@ @ ^@ `OJQJo(hHh^`OJQJ^Jo(hHoh^`OJQJo(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohPP^P`OJQJo(hH P^`PhH @@^@`hH. 0^`0hH.. ``^``hH... ^`hH .... ^`hH ..... ^`hH ......  `^``hH.......  00^0`hH........4 (s[&%(`\4Y`9&7n5d>l@2JEQ V b\hInhB#. `ftC"g "1fzh?zKUf9DF8067t!567123Ndyz{"#$%&2]^`abcw@(fP@UnknownGz Times New Roman5Symbol3& z Arial7&  Verdana?5 z Courier New;Wingdings"0hFF[Fb b $4d$$k2qHX?`2PjCom9  Amended 13 Aug Lis Bovellacharles  Oh+'0  8 D P \hpxPjCom9 Amended 13 Aug Lis Bovell Normal.dot acharles2Microsoft Office Word@@1^@j# I@j# Ib՜.+,0 hp|  STM $ PjCom9 Amended 13 Aug Title  !"#$%&'()*+,-./0123456789;<=>?@ABCDEFGHIJKLMNOPQSTUVWXY[\]^_`adRoot Entry F)IfData 61Table:r.WordDocument3:SummaryInformation(RDocumentSummaryInformation8ZCompObjq  FMicrosoft Office Word Document MSWordDocWord.Document.89q