EQUAL OPPORTUNITY EMPLOYMENT SURVEY
The following information is being sought only for the purpose of compliance with the Public Contracts Act
and will be used only for purposes of reporting. You are not required to provide this information.

Position Applied For:

Male


Female

Minority Status

American Indian/Alaskan Native
(Not Hispanic or Latino)

Hispanic or Latino

Native Hawaiian/Other Pacific Islander
(Not Hispanic or Latino)

Two or more races









Caucasian


Black or African American


Asian
(Not Hispanic or Latino)

 





Do you have a dilsability? Yes No

** "Disabled Person" is defined as a person who has a physical or mental impairment that substantially limits one or more major life activities or has a record of or is regarded as having such impairment. "Substantially Limiting" means to the degree that impairment affects employability. "Disabled Individual" does not include an
alcohol or drug abuser whose current use of alcohol or drugs renders that
individual a hazard to the individual or others.