Individual Council logo to be added here
EQUAL EMPLOYMENT OPPORTUNITY
Note: We are requesting EEO information on a voluntary basis. The purpose of requesting this information
is to monitor our effectiveness in attracting minorities. The information collected is confidential. Please check
how you would designate yourself racially and/or culturally:
Are you of Hispanic origin (This is defined as being a person of Mexican, Puerto Rican, Cuban, South American, or other Spanish Culture or origin, regardless of race)?
_____Yes or _____No
Race:
[ ] Caucasian
[ ] African American
[] Asian or Pacific Islander- a person with origins in any of the original peoples of the Far East, Southeast Asia, the Indian subcontinent, or the Pacific Islands. This area includes, for example, China, Japan, Korea, the Philippine Republic, and Samoa.
[] Native American or Alaskan Native- A person with origins in any of the original people of North America and who maintains cultural identification through tribal affiliation or community recognition.
[] Multi-Cultural - a person who would classify themselves as more than one of the
above.
References:
Name_______________________________Title/Relationship________________________
Organization Name___________________________________________________________
Address____________________________________________________________________
____________________________________Telephone______________________________
Personal Professional E-mail_______________________________
Name_______________________________Title/Relationship________________________
Organization Name___________________________________________________________
Address____________________________________________________________________
____________________________________Telephone______________________________
Personal Professional |
E-mail_______________________________ |