EEOC - 1 Voluntary Self Identification Form

Addison Group is an equal employment opportunity employer. As required by law, we must record certain information to be in compliance with Equal Employment Opportunity Office (EEOC)

The information on this EEO Self Identification Form is being requested and will be used solely for equal employment opportunity record‐keeping and reporting purposes. Submission of this form by you is voluntary and confidential. Please be assured that you will not be subjected to any adverse treatment if you do not provide the information requested. In the event that you do provide the information requested, the information and this form will be processed and maintained separately from your application and personnel file.

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Name

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E-mail address

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Date

Date

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Please specify your graduation date in the following format (MM/YYYY)

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Gender

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Race/Ethnicitiy

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