Voluntary Self-Identification Of Veterans Form Page 2
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2Voluntary Self-Identification of Veterans
Reasonable Accommodation Notice
If you are a disabled veteran it would assist us if you tell us whether there are accommodations we could make that
would enable you to perform the essential functions of the job, including special equipment, changes in the physical
layout of the job, changes in the way the job is customarily performed, provision of personal assistance services or other
accommodations. This information will assist us in making reasonable accommodations for your disability.
Submission of this information is voluntary and refusal to provide it will not subject you to any adverse treatment. The
information provided will be used only in ways that are not inconsistent with the Vietnam Era Veterans' Readjustment
Assistance Act of 1974, as amended.
The information you submit will be kept confidential, except that (i) supervisors and managers may be informed
regarding restrictions on the work or duties of disabled veterans, and regarding necessary accommodations; (ii) first aid
and safety personnel may be informed, when and to the extent appropriate, if you have a condition that might require
emergency treatment; and (iii) Government officials engaged in enforcing laws administered by the Office of Federal
Contract Compliance Programs, or enforcing the Americans with Disabilities Act, may be informed.
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