(For Statistical Purposes Only)
The City of Fairfield is interested in monitoring the demographics of applicants as well as employees in order to acquire data for
EEOC and OH Civil Rights reporting. Please assist us by filling out and returning this form. You may return this form with your
application or separately to the City of Fairfield, Human Resources, 5350 Pleasant Avenue, Fairfield, OH 45014.
this form is voluntary and your failure to provide this information will have no effect on your employment prospects with the
City of Fairfield.
POSITION APPLIED FOR:
________American Indian or Alaskan
________Asian or Pacific Islander
How did you find out about this job opening?
________The Center for Local Government
________City of Fairfield Web-site