Form Sna-1023a - Agreement For Work Experience And Community Service Activities Page 2
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2SNA-1023A FORFF (7-17) – Reverse
Equal Opportunity Employer/Program • Under Titles VI and VII of the Civil Rights Act of 1964 (Title VI & VII), and the
Americans with Disabilities Act of 1990 (ADA), Section 504 of the Rehabilitation Act of 1973, the Age Discrimination Act of
1975, and Title II of the Genetic Information Nondiscrimination Act (GINA) of 2008; the Department prohibits discrimination in
admissions, programs, services, activities or employment based on race, color, religion, sex, national origin, age, disability,
genetics and retaliation. The Department must make a reasonable accommodation to allow a person with a disability to take
part in a program, service or activity. Auxiliary aids and services are available upon request to individuals with disabilities.
For example, this means if necessary, the Department must provide sign language interpreters for people who are deaf, a
wheelchair accessible location, or enlarged print materials. It also means that the Department will take any other reasonable
action that allows you to take part in and understand a program or activity, including making reasonable changes to an
activity. If you believe that you will not be able to understand or take part in a program or activity because of your disability,
please let us know of your disability needs in advance if at all possible. To request this document in alternative format
or for further information about this policy, contact your local office manager; TTY/TDD Services: 7-1-1. • Free language
assistance for DES services is available upon request.
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