EEO Self-Identification Form (Voluntary Information-Not Required)

2. 
4. Qualified applicants are considered for employment without regard to race, religion, sex, national origin, age, marital status, sexual orientation, veteran status, disability, or other protected characteristics. The City of Gulf Shores is subject to certain governmental recordkeeping and reporting requirements for the administration of civil rights laws and regulations. In order to comply with these laws, the City invites applicants and employees to voluntarily self-identify their race or ethnicity. Submission of this information is voluntary and refusal to provide it will not subject you to any adverse treatment. The information obtained will be kept confidential and may only be used in accordance with the provisions of applicable laws, executive orders, and regulations, including those that require the information to be summarized and reported to the federal government for civil rights enforcement. This form will be kept in a confidential file separate from your application for employment.
6. First Name
7. Last Name
9. Date
   Date
10. Specific Position Applied For
12. Check One:

    1. Male
    2. Female
13. Select One: (Race/Ethnic Origin)*
    -- Select One --American Indian/Alaskan NativeAsian/Pacific IslanderBlack (not of Hispanic Origin)HispanicCaucasianOther
14. Check any of the following if applicable:

    1. Diabled Veteran
    2. Veteran
    3. Non-Veteran
    4. I need a job accomodation
16. How did you learn about this job opening? Select one
    -- Select One --NewspaperEmployment AgencyUnemployment OfficeCall/Walk InCollegeInternetReferralOther
Leave This Blank:


18. 1. Receive an email copy of this form.
19. Email address

    This field is not part of the form submission.

20. Submit

* indicates a required field