X hits on this document

17 views

0 shares

0 downloads

0 comments

9 / 9

Equal Employment Opportunity/Affirmative Action Data

Maxum Petroleum and its subsidiaries comply with all equal employment opportunity and affirmative action laws and regulations. Employment decisions are made on the basis of job-related criteria without regard to age, race, religion, color, sex, national origin, sexual orientation, ancestry, military status, marital status or physical or mental disability.

To maintain accurate data for our equal employment opportunity and affirmative action programs, we request that you complete any of the voluntary sections that apply to you. You will not be subject to adverse treatment either by providing the information or by failing to complete the sections.

This sheet will be retained in a confidential file separate from your personal records. Its only purpose is to assist us in preparing reports for corporate and governmental monitoring activities. If you want more information about any of the sections, please check with a Maxum employment representative.

Name:

(Last)

(First)

(Date)

Address:

(Street)

(City)

(State)

(Zip Code)

Type of work for which you are applying:

BLACK or AFRICAN AMERICAN ............................................................................................................................... A person having origins in any of the Black racial groups of Africa.

Male Female

HISPANIC or LATINO ................................................................................................................................................. A person of Mexican, Puerto Rican, Cuban, Chicano, Central and South American or other Spanish culture regardless of race.

Male Female

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, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.

Male Female

NATIVE HAWAIIAN or OTHER PACIFIC ISLANDER................................................................................................. A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.

Male Female

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 cultural identification through tribal affiliation or community recognition.

Male Female

WHITE ........................................................................................................................................................................ A person having origins in any of the original peoples in Europe, North Africa, or the Middle East.

Male Female

TWO OR MORE RACES ............................................................................................................................................ A person who primarily identifies with two or more of the above race/ethnicity categories.

Male Female

DECLINED TO IDENTIFY ..........................................................................................................................................

RACIAL/ETHNIC GROUP VOLUNTARY SELF-IDENTIFICATION (Please mark the appropriate box)

2011 Maxum Petroleum, Inc.

500 River East Drive | Belle, WV 25015 | (304) 926-3002 | www.maxumpetroleum.com

Document info
Document views17
Page views17
Page last viewedSun Dec 04 08:26:26 UTC 2016
Pages9
Paragraphs363
Words2554

Comments