INDEPENDENT ADVISORY GROUP SKILLS AUDIT
| Title | |
| First Name | |
| Last Name | |
| Any other name by which you are known | |
| IAG Area | |
| Home Address | |
| Telephone | |
| Mobile Telephone | |
| Email Address | |
| Contact Details
Is there anything we should know about contacting you? (e.g. please allow me time to answer or only contact me by email) |
|
| Date of Birth (optional) | |
| Reflective Community |
| Skills
Do you have any skills that you are happy to use when working with us? (e.g. what languages do you speak, are you able to use sign language etc.) |
|
| Personal Attributes
Please use this section to focus on the qualities you will bring to the role as an Independent Advisor (e.g. skills in project management, experience you have of working with others on strategic matters, or developing new/embryonic groups) |
|
| Other
Anything else you may wish to tell us about |
Do you consider yourself to have a disability?
Yes No Rather not say
ETHNICITY
Asian or Asian British White
Bangladeshi White British
Indian White Irish
Pakistani Any Other White Background
Any Other Asian Background
Black or Black British Other Ethnic Group
African Chinese
Caribbean Gypsy/Traveller
Any Other Black Background Any Other Ethnic Group (please state)
Mixed
White and Asian
White and Black African
White and Black Caribbean
Any Other Mixed background
Rather not say
GENDER
Female
Male
Transgender
Rather not say
RELIGION OR BELIEFS
Atheism Judaism
Buddhism Sikhism
Christianity No Religion
Hinduism
Islam
I do not wish to disclose my Religion/Belief
Any other Religion/Belief
(please specify)
SEXUAL ORIENTATION
Bisexual Heterosexual
Gay Other
Lesbian Rather not say
Skills Audit Word
Skills Audit PDF
