Fillable Eeo Candidate Voluntary Self-Identification Form (Page 2 of 2) in pdf

Veteran Status Pre-Offer Solicitation

Name: __________________________________________________________

Date: _________________________

Chemonics International is a government contractor subject to the Vietnam Era Veterans’ Readjustment Assistance Act

of 1974, as amended by the Jobs for Veterans Act of 2002,

38 U.S.C. 4212

(VEVRAA), which requires government

contractors to take affirmative action to employ and advance in employment:

(1) Disabled veterans

(2) Recently separated veterans

(3) Active duty wartime or campaign badge veterans

(4) Armed Forces service medal veterans

These classifications are defined as follows:

• A disabled veteran is one of the following:

– A veteran of the U.S. military, ground, naval, or air service who is entitled to compensation (or who but

for the receipt of military retired pay would be entitled to compensation) under laws administered by the

secretary of Veterans Affairs

– A person who was discharged or released from active duty because of a service-connected disability

• A recently separated veteran is any veteran during the three-year period beginning on the date of such veteran’s

discharge or release from active duty in the U.S. military, ground, naval, or air service

• An active duty wartime or campaign badge veteran is a veteran who served on active duty in the U.S. military,

ground, naval, or air service during a war or in a campaign or expedition for which a campaign badge has been

authorized under the laws administered by the U.S. Department of Defense

• An Armed Forces service medal veteran is a veteran who, while serving on active duty in the U.S. military,

ground, naval, or air service, participated in a U.S. military operation for which an Armed Forces service medal

was awarded pursuant to

Executive Order

12985.

Protected veterans may have additional rights under the Uniformed Services Employment and Reemployment Rights

Act. In particular, if you were absent from employment to perform service in the uniformed service, you may be

entitled to be reemployed by your employer in the position you would have obtained with reasonable certainty if not

for the absence due to service. For more information, call the U.S. Department of Labor’s Veterans Employment and

Training Service, toll-free, at 1-866-4-USA-DOL.

If you believe you belong to any of the categories of protected veterans listed above, please indicate by checking the

appropriate box below. As a government contractor subject to VEVRAA, we request this information to measure the

effectiveness of the outreach and positive recruitment efforts we undertake pursuant to VEVRAA.

□

I identify as one or more of the classifications of protected veterans listed above

□

I am not a protected veteran

□

I decline to disclose my veteran status

Eeo Candidate Voluntary Self-Identification Form Page 2