"*" indicates required fields It is the policy of this organization to provide equal employment opportunity to all qualified applicants for employment without regard to race, color, national origin, sex, religion, age, disability, serious medical conditions, veteran status, sexual orientation, gender identity, spousal affiliation, or any other status protected by law. Various agencies of the government require employers to invite applicants to identify themselves as indicated below. COMPLETION OF THIS FORM IS VOLUNTARY AND IN NO WAY AFFECTS THE DECISION REGARDING YOUR APPLICATION FOR EMPLOYMENT. THIS FORM IS CONFIDENTIAL AND WILL BE MAINTAINED SEPARATELY FROM YOUR APPLICATION FORM.Name* First M.I. Last Position Applied for (list only one) What is your sex? Male Female What is your race/ethnic origin? White Hispanic or Latino American Indian/Alaskan Native Black or African American Asian Native Hawaiian or Other Pacific Islander Other Two or More Races EmailThis field is for validation purposes and should be left unchanged.
