Voluntary Applicant Survey

As an Equal Opportunity employer, we gather demographic information both about our applicants and employees. Your assistance in this process would be most helpful. Participation is strictly voluntary and refusal to provide it will not subject you to any adverse treatment. When reported, the information you provide will not identify you as an individual, will remain confidential, and be used only to fulfill our EEO obligations. Please take a few moments to complete and return the survey.

Position Applied For:

Date

Gender

Male
Female

Race/Ethnicity

Please mark the single most appropriate race or ethnic group

White - A person with origins in any of the original peoples of Europe, the Middle East, or North Africa.
Black or African American - A person with origins in any of the Black racial groups of Africa
Hispanic or Latino - A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race.
Native Hawaiian or Pacific Islander - A person with origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.
Asian - A person with origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent, including China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, Vietnam, Cambodia and Laos.
American Indian or Alaska Native - A person with origins in the original peoples of North, Central, and South America, and who maintains tribal affiliation or community attachment
Two or More Races - All persons who identify with more than one of the above five races.

Other Status

Veteran
Disabled
Decline to Self-Identify

Watch Test

Voluntary Applicant Survey

Voluntary Applicant Survey