Job Application Self Identification Form

Job Application Self Identification Form

We are a government contractor subject to all provisions of The Civil Rights Act of 1964, Executive Order 11246 (as amended), The Rehabilitation Act of 1973 (as amended), and The Vietnam Era Veterans’ Readjustment Assistant Act of 1974 (as amended). Qualified applicants are considered without regard to race, color, sex, age, religion, national origin, genetic information, pregnancy, disability, or protected veteran status.

In order to help us comply with government regulations, we would like you to answer the questions listed below. YOU ARE NOT REQUIRED TO PROVIDE THIS INFORMATION. This form will be kept strictly confidential and separate from your Employment Application.

Privacy Disclosure:

Our Privacy Disclosure protects the privacy of your personally-identifying information that you provide us online.

Security Notice:

You should ONLY fill out this application online if you are using a browser with the latest security enhancements. If you don’t have the latest version, download a copy now. This form is NOT cached (saved in your computer’s memory) when you exit your browser.

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  • Self-identified gender information will only be used for statistical purposes and/or required reporting to various government agencies. This information will be kept confidential, will only be used in accordance with applicable laws, and will not affect any decisions regarding your employment.
  • We are obliged to file this information periodically with various government agencies for statistical reports. This information will not affect the decision regarding your application for employment, and it will be kept confidential.
  • “Protected” veterans include the following categories: (1) disabled veterans; (2) recently separated veterans; (3) active duty wartime or campaign badge veterans; and (4) Armed Forces service medal veterans. These categories are defined as follows: (1) A “disabled veteran” is (i) a veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who, but for the receipt of military retired pay, would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs; or (ii) a person who was discharged or released from active duty because of a service-connected disability. (2) A “recently separated veteran” means any veteran during the 3-year period beginning on the date of such veterans discharge or release from active duty in the U.S. military, ground, naval, or air service. (3) An “active duty wartime or campaign badge veteran” means a veteran who served on active duty in the U.S. military, ground, naval or air service during a war, or in a campaign or expedition for which a campaign badge has been authorized under the laws administered by the Department of Defense. (4) An “Armed forces service medal veteran” means a veteran who, while serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985.
  • An individual with disability is any person who (1) has a physical or mental impairment which substantially limits one or more of such person’s major life activities; (2) has a record of such impairment; or (3) is regarded as having such impairment.