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VOLUNTARY SELF-IDENTIFICATION FORM FOR APPLICANTS
Carnegie Institution of Washington is an equal
opportunity employer and committed to fostering a diverse
workforce. It is our policy to administer all personnel
actions including recruiting, hiring, training, and
promoting employees without regard to race, color, religion,
sex, sexual orientation, national origin, age, disability,
marital status, veteran status, or any other legally
protected classification in accordance with applicable
federal and state laws. Consistent with the obligations
of these laws, Carnegie Institution of Washington will
make reasonable accommodations for qualified individuals
with disabilities. In addition, as a federal government
contractor, the Institution maintains an affirmative
action program which furthers its commitment and complies
with recordkeeping and reporting requirements under
certain federal civil rights laws and regulations,
including Executive Order 11246, Section 503 of the
Rehabilitation Act of 1973 and the Vietnam Era
Veterans' Readjustment Assistance Act of 1974, as amended.
As part of our compliance with these obligations, the
Institution invites you to voluntarily self-identify as
set forth below. Provision of the following information
is entirely voluntary and a decision to provide or not
provide such information will not have any effect on your
employment or subject you to any adverse treatment. Any
and all information provided will be considered
confidential, will be kept separate from your application
and/or personnel file, and will only be used in accordance
with applicable laws, orders and regulations, including
those that require the information to be summarized and
reported to the federal government for civil rights enforcement
purposes.
DEFINITIONS FOR VOLUNTARY SELF-IDENTIFICATION
Hispanic or Latino -- A person having origins of
Cuban, Mexican, Puerto Rican, Central or South American or
other Spanish culture of origin, regardless of race.
American Indian or Alaskan Native -- A person
having origins in any of the original peoples of North and
South America (including Central America), and who maintains tribal
affiliation or community attachment.
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.
Native Hawaiian or Other Pacific Islander -- A
person having origins in any of the peoples of Hawaii, Guam,
Samoa, or other Pacific Islands.
Black or African American -- A person having
origins in any of the Black racial groups of Africa.
White/Caucasian -- A person having origins in any
of the original peoples of Europe, the Middle East, or North Africa.
Protected Veteran Categories:
Disabled Veteran -- A veteran of the U.S. military, ground,
naval, or air service who is entitled to compensation (or who but for
the receipt of military retired pay would be entitled to compensation)
under laws administered by the Secretary of Veterans Affairs, or a
person who was discharged or released from active duty because of a
service-connected disability.
Recently Separated Veteran -- A veteran during the three-year
period beginning on the date of such veteran's discharge or release from
active duty in the U.S. military, ground, naval, or air service.
Armed Forces Service Medal Veteran -- A veteran who, while
serving on active duty in the U.S. military, ground, naval or air
service, participated in a United States military operation for which
an Armed Forces service medal was awarded pursuant to Executive Order
12985.
Active Duty Wartime or Campaign Badge Veteran -- A veteran
who served on active duty in the U.S. military, ground, naval or air
service during a war or in a campaign or expedition for which a campaign
badge has been authorized, under the laws administered by the
Department of Defense.
Read Carefully Before "Signing"
I certify that the information I have provided to the
foregoing questions is true and correct, and no attempt
has been made to conceal pertinent information. I
authorize my former employers, school, and business
references to provide any information they may have
regarding me, whether or not it is in my records. I
hereby release them and their company from all liability
for divulging same. I understand that all statements made
are open to investigation by Carnegie Institution of
Washington and that if any information given by me in this
application, is found to be false or misleading, I will be
subject to dismissal at anytime during the period
of employment and I agree to hold the Carnegie Institution
of Washington and persons named herein blameless in the
event.
I understand that this employment application and any
other Carnegie Institution of Washington documents are not
contracts of employment; therefore, under proper notice, I
may voluntarily leave the Institution at any time and,
likewise, the Carnegie Institution of Washington may at
any time terminate my employment, and that any oral and
written statement to the contrary are not binding and,
therefore, should not be relied upon.
