Employment Application - City Of Newport (Page 8 of 9) in pdf

Employment Application - City Of Newport Page 8

CITY OF NEWPORT

169 SW Coast Highway, Newport, Oregon 97365

EEO Voluntary Information

The information you provide below is voluntary.

The City of Newport is an equal opportunity employer. To help us comply with government recordkeeping, reporting, and other legal

requirements, please complete the voluntary section below. Providing this is voluntary and this form will be kept in a confidential file separate

from the application form.

Gender:

☐ Male

☐ Female

Race/Ethnicity: (Please check one below)

☐ Hispanic or Latino – A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture of origin regardless of

race.

☐ White (Not Hispanic or Latino): - A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.

☐ Black or African American (Not Hispanic or Latino): - A person having origins in any of the black racial groups of Africa.

☐ 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.

☐ American Indian or Alaska Native (Not Hispanic or Latino): - A person having origins in any of the original peoples of North and South

America (including Central America), and who maintain tribal affiliation or community attachment.

☐ Two or More Races (Not Hispanic or Latino): - All persons who identify with more than one of the above five races.

☐ Veteran

☐ Non-Veteran

Disability: Any physical and/or mental condition which might cause you difficulty in securing, retaining, or advancing in employment. If you

are disabled, please check the “YES” box.

☐ YES

☐ NO

Employment Application - City Of Newport Page 8