Affirmative Action: Applicant Invitation to Self-Identify

    Applicants for employment are invited to participate in the affirmative action program by reporting their status as a protected veteran or other minority. In extending this invitation, we advise you that; (a) workers (applicants) are under no obligation to respond but may do so in the future if they choose; (b) responses will remain confidential within the human resource department; and (c) responses will be used only for the necessary information to include in our affirmative action reporting program. We are a company that values diversity. We actively encourage women, minorities, veterans and disabled employees to apply. Refusal to provide this information will have no bearing on your application and will not subject you to any adverse treatment.

    I do not wish to self-identify

    Name:

    Position Applied For:

    Applicant Information

    Position Applied For:

    Gender: MaleFemaleNon-Binary/Transgender/Gender Non-conformingDo not wish to answer

    Race or Ethnicity Identity (Select One) Hispanic or Latino - A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin regardless of race.White (not Hispanic or Latino) - A person having origins in any of the original peoples of Europe, the Middle East or North Africa.Black or African American (not Hispanic or Latino) - A person having origins in any of the black racial groups of Africa.Native Hawaiian or Pacific Islander (not Hispanic or Latino) - A person having origins in any of the peoples of Hawaii, Guam, Samoa or other Pacific Islands.Asian (not Hispanic or Latino) - A person having origins in any of the original peoples of the Far East, Southeast Asia or the Indian Subcontinent, including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand and Vietnam.American Indian or Alaskan Native (not Hispanic or Latino) - A person having origins in any of the original peoples of North and South America (including Central America) and who maintain tribal affiliation or community attachment.Two or more races (not Hispanic or Latino) - All persons who identify with more than one of the above races.

    Military Status:

    I am a VeteranI am NOT a Veteran

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