(Confidential-For Statistical Use Only)
We are an equal opportunity employer and do not discriminate on the basis of
race, color, religion, sex, age, national origin, disability, veteran status,
sexual orientation or any other classification protected by federal, state or
local law. The information below will be used only in the compilation of data
for government required reporting.
Completion of this data is voluntary and will not affect the terms or conditions
of your emplyment.
PLEASE COMPLETE IN FULL:
(Please check one of the descriptions below corresponding to the ethnic group
with which you most identify.)