Please fill out the form below and click Submit to submit your application for consideration. Loading, please wait. Yes No. We are an Equal Opportunity employer and do not discriminate on the basis of race, ancestry, color, religion, sex, age, marital status, sexual orientation, national origin, medical condition, disability, veteran status, or any other basis protected by law.
The information provided will be used for research, reporting, statistical purposes and to monitor legal compliance. To help us comply with these government requirements, please complete the following information. Completion of this form is voluntary and will not affect your opportunity for employment or terms or conditions of employment if hired.
We appreciate your cooperation. A person having origins in any of the Black racial groups of Africa. A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.
All persons who identify with more than one of the above races. Veteran Status: Please check all that apply Individual with a Disability An individual with a disability is a person who has a physical or mental impairment which substantially limits one or more of such person's major life activities, or who has a record of such impairment. A person who 1 Served on active duty for a period of more than days, and was discharged or released therefrom with other than a dishonorable discharge, if any part of such active duty occurred; a.
A veteran who served on active duty in the U. A veteran who, while serving on active duty in the U. Any veteran during the three-year period beginning on date of such veteran's discharge or release from active duty in the U. Copyright Champion, Partners in Rehab. All rights reserved. American Indian or Alaska Native Not Hispanic or Latino A person having origins in any of the original peoples of North America and South America including Central America , and who maintains tribal affiliation or community attachment.
