Application For Employment Form 2015 (Page 3 of 3) in pdf

EQUAL EMPLOYMENT OPPORTUNITY

The Commitment of Youngstown Area Goodwill Industries, Inc. to a policy of equal employment opportunity requires

that certain information be gathered and documented for statistical purposes only. Your cooperation in completing this

section would be greatly appreciated.

This page will be detached from the application form immediately upon completion and submission by you, and

any information volunteered will be kept confidential and will not be used to make hiring decisions.

Today’s Date

Name: _____________________________________________

Last

First

M.I.

Sex:

Male

Female

Please check the appropriate race:

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

culture or 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.

Native Hawaiian or Other Pacific Islander (Not Hispanic or Latino) – A person having origins in any of

the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.

Asian (Not Hispanic or Latino) – 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) –A person who identify with more than one of the above five races.

For what position are you applying:____________________________________________________________

How were you referred to us?

Associate Referral___________________________

Check if this Associate is a family member

(Name of Associate)

Goodwill Placement Dept.

Newspaper

Other (please specify)_________________

Internet

Walk-In

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Application For Employment Form 2015 Page 3