Eeo 1 Self Identification Form 2020 Details

Employers are required to provide employees a way to self identify their protected status. The eeo voluntary self identification form is used to identify an individual's race, color, national origin, sex, and religion. This information is used by employers to comply with EEO reporting requirements. Completing the form is voluntary and confidential. Employees can submit the form to their supervisor or follow instructions on how to complete the form online.

We've collected some general information about the eeo voluntary self identification. This table will provide information about the form's length, finalization time, and the parts you're needed to fill.

Form NameEeo Voluntary Self Identification
Form Length2 pages
Fillable fields24
Avg. time to fill out5 min 22 sec
Other nameseeo voluntary self identification, eeo 1 self identification form 2020, eeo 1 self identification form 2021, eeo voluntary form

Form Preview Example

EEO Candidate Voluntary Self-Identiication

Chemonics International

Chemonics believes that all persons are entitled to equal employment opportunities and we do not discriminate against

our employees, applicants, or job seekers because of race, color, gender, religion, national origin, disability, veteran status, age, marital status, or any other protected group status as deined by the laws. In order to comply with the laws, we invite you to voluntarily self-identify your race/ethnicity, gender, and veteran status. Please complete the information below, which includes the option to choose not to self-identify, and return as instructed as soon as possible.

This information will be kept conidential and separate from the application for employment. Your submission of this information is entirely voluntary and refusal to provide it will not inluence our screening or hiring decisions.

NAME: ________________________________________________________


Position Applied For: ___________________________________________________________________________

Referral Source: Internal (Current Employee)



Employment Agency

Other: ______________________________________


(please specify)


I do not wish to complete the information requested below.







Black/African American



American Indian/Alaskan Native



Native Hawaiian or Other Paciic Islander Two or More Races (Not Hispanic or Latino)

Race/Ethnic Deinitions:

Hispanic/Latino: A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race.

Black/African American (not Hispanic or Latino): A person having origins in any of the black racial groups of Africa.

White (not Hispanic or Latino): A person having origins in any of the original peoples of Europe, the Middle East, or

North Africa.

American Indian/Alaskan Native (not Hispanic or Latino): A person having origins in any of the original peoples of

North and South America (including Central America) and who maintain tribal afiliation or community attachment.

Asian (not Hispanic or Latino): 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 Paciic Islander (not Hispanic or Latino): A person having origins in any of the peoples of

Hawaii, Guam, Samoa, or other Paciic Islands.

Two or More Races (not Hispanic or Latino): A person who identiies with two or more race categories named above.

Veteran Status Pre-Offer Solicitation

NAME: __________________________________________________________ DATE:_________________________

Chemonics International is a government contractor subject to the Vietnam Era Veterans’ Readjustment Assistance Act of 1974, as amended by the Jobs for Veterans Act of 2002, 38 U.S.C. 4212 (VEVRAA), which requires government contractors to take afirmative action to employ and advance in employment:

(1)Disabled veterans

(2)Recently separated veterans

(3)Active duty wartime or campaign badge veterans

(4)Armed Forces service medal veterans

These classiications are deined as follows:

A disabled veteran is one of the following:

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

A person who was discharged or released from active duty because of a service-connected disability

A recently separated veteran is any 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

An active duty wartime or campaign badge veteran is 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 U.S. Department of Defense

An Armed Forces service medal veteran is a veteran who, while serving on active duty in the U.S. military, ground, naval, or air service, participated in a U.S. military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985.

Protected veterans may have additional rights under the Uniformed Services Employment and Reemployment Rights Act. In particular, if you were absent from employment to perform service in the uniformed service, you may be

entitled to be reemployed by your employer in the position you would have obtained with reasonable certainty if not for the absence due to service. For more information, call the U.S. Department of Labor’s Veterans Employment and Training Service, toll-free, at 1-866-4-USA-DOL.

If you believe you belong to any of the categories of protected veterans listed above, please indicate by checking the appropriate box below. As a government contractor subject to VEVRAA, we request this information to measure the effectiveness of the outreach and positive recruitment efforts we undertake pursuant to VEVRAA.

I identify as one or more of the classiications of protected veterans listed above

I am not a protected veteran

I decline to disclose my veteran status

How to Edit Eeo Voluntary Self Identification

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stage 1 to completing eeo 1 self identification form 2021

You need to provide your details inside the area Name:, Chemonics International is a, (1) Disabled veterans, (2) Recently separated veterans, (3) Active duty wartime or, (4) Armed Forces service medal, and These classiications are deined as.

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