GREATER LOS ANGELES AGENCY ON DEAFNESS, INC. VOLUNTARY EMPLOYMENT QUESTIONNAIRE
Applicant: This completed section is confidential and will be detached from your application. This information is voluntary and is gathered in accordance with State and Federal laws for the purpose of evaluating the effectiveness of our equal opportunity and recruitment efforts.
NAME (Optional) Job Title CHECK ONE: Male Female PLEASE CHECK ONE BOX ONLY FOR THE RACIAL/ETHNIC CATEGORY WITH WHICH YOU MOST CLOSELY IDENTIFY WITH (SEE BELOW FOR THE ETHNIC DEFINITIONS)
(Not Hispanic Origin) All persons having origins in any of the original peoples of Europe, North Africa, or the Middle East.
(Not Hispanic Origin) All persons having origins in any of the Black racial groups of Africa.
All persons of Mexican, Puerto Rican, Cuban, or any other Spanish Hispanic (does not include persons of Portuguese or Brazilian origin or persons who acquire a Spanish surname).
ASIAN OR PACIFIC ISLANDER
All persons having origins in any of the original peoples of the Far East, Southeast Asia, the Indian Subcontinent, or the Pacific Islands (excluding the Philippine islands). These areas include for example, China, Japan, Korea, and Samoa.
AMERICAN INDIAN OR ALASKAN NATIVE
All persons having origins in any of the original peoples of North America, or/and who maintain cultural identifications through tribal affiliation or community recognition. PLEASE IDENTIFY YOUR TRIBAL AFFILIATION:
All persons having origins in the Philippine islands.
How did you learn about us?