Voluntary Self-Identification Form
Please complete the following as part of the application process.
Our company is an Affirmative Action/Equal Employment Employer and as such, we are required to collect and maintain information related to applicants in order to meet governmental record-keeping and reporting requirements and to monitor the effectiveness of our outreach, recruitment and other employment practices.
At this time, we are asking you to help us meet our obligations by providing the information listed on the following pages. Please note that the information will be used only in accordance with the provisions of applicable laws, executive orders, and regulations. Providing this information is voluntary and refusal to do so will not result in any adverse treatment. The information you provide will be held in strict confidence except that:
- Necessary management and supervisory personnel may be informed to ensure proper placement and to provide reasonable job accommodations;
- First aid and safety personnel may be informed to the extent appropriate, if the condition might require emergency treatment; and
- Government officials investigating affirmative action program compliance may have access to reported information.
Thank you for your cooperation in this important initiative.
Martin/Martin, Inc. abides by the requirements of federal laws which prohibit discrimination and require affirmative action by covered prime contractors and subcontractors to employ and advance in employment qualified individuals with the following legally protected status: race, color, religion, sex, national origin (per Executive Order 11246), disability (per 41 CFR 60-741.5(a), and protected veterans (per 41 CFR 60-300.5(a).