Ethnicity, Race, and Disability

Next Step

In order to ensure your application is complete and processed fully, you must fill out the Ethnicity and Race form as well.

  • Please complete the following form. This must be completed for our employment application process.

  • Privacy Act Statement

    Ethnicity and race information is requested under the authority of 42 U.S.C. Section 2000e-16 and in compliance with the Office of Management and Budget's 1997 Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity. Providing this information is voluntary and has no impact on your employment status, but in the instance of missing information, your employing agency will attempt to identify your race and ethnicity by visual observation.

    This information is used as necessary to plan for equal employment opportunity throughout the Federal government. It is also used by the U. S. Office of Personnel Management or employing agency maintaining the records to locate individuals for personnel research or survey response and in the production of summary descriptive statistics and analytical studies in support of the function for which the records are collected and maintained, or for related workforce studies.

    Social Security Number (SSN) is requested under the authority of Executive Order 9397, which requires SSN be used for the purpose of uniform, orderly administration of personnel records. Providing this information is voluntary and failure to do so will have no effect on your employment status. If SSN is not provided, however, other agency sources may be used to obtain it.

  • Ethnicity & Race

    Specific Instructions: The two questions below are designed to identify your ethnicity and race. Regardless of your answer to question 1, go to question 2.
  • (A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race.)

  • Racial Category Explanation

    American Indian or Alaska Native — A person having origins in any of the original peoples of North and South America (including Central America), and who maintains tribal affiliation or community attachment.

    Asian — A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.

    Black or African American — A person having origins in any of the black racial groups of Africa.

    Native Hawaiian or Other Pacific Islander — A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.

    White — A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.

  • Disability

  • Why are you being asked to complete this form?

    We are a federal contractor or subcontractor required by law to provide equal employment opportunity to qualified people with disabilities. We are also required to measure our progress toward having at least 7% of our workforce be individuals with disabilities. To do this, we must ask applicants and employees if they have a disability or have ever had a disability. Because a person may become disabled at any time, we ask all of our employees to update their information at least every five years.

    Identifying yourself as an individual with a disability is voluntary, and we hope that you will choose to do so. Your answer will be maintained confidentially and not be seen by selecting officials or anyone else involved in making personnel decisions. Completing the form will not negatively impact you in any way, regardless of whether you have self-identified in the past. For more information about this form or the equal employment obligations of federal contractors under Section 503 of the Rehabilitation Act, visit the U.S. Department of Labor's Office of Federal Contract Compliance Programs (OFCCP) website www.dol.gov/ofccp.

    How do you know if you have a disability?

    You are considered to have a disability if you have a physical or mental impairment or medical condition that substantially limits a major life activity, or if you have history or record of such an impairment or medical condition. Disabilities include, but are not limited to:

    • Autism
    • Autoimmune disorder, for example, lupus, fibromyalgia, rheumatoid arthritis, or HIV/AIDS
    • Blind or low vision
    • Cancer
    • Cardiovascular or heart disease
    • Celiac disease
    • Cerebral palsy
    • Deaf or hard of hearing
    • Depression or anxiety
    • Diabetes
    • Epilepsy
    • Gastrointestinal disorders, for example, Crohn's Disease, or irritable bowel syndrome
    • Intellectual disability
    • Missing limbs or partially missing limbs
    • Nervous system condition for example, migraine headaches, Parkinson's disease, or Multiple sclerosis (MS)
    • Psychiatric condition, for example, bipolar disorder, schizophrenia, PTSD, or major depression
  • This field is for validation purposes and should be left unchanged.