forminator forms one eeo disclosure

EEO-1 Voluntary Self-Identification Form

Because we do business with the government, and to comply with the regulations for equal employment opportunity and affirmative action (EEO/AA), we must track our applicants by gender and race/ethnicity and the position they applied for to the government. We are an organization that values diversity and encourages women and minorities to apply. For this reason, we invite you to indicate your gender and race/ethnicity below. This information is kept separate from your application.

Submission of this information is voluntary and refusal to provide it will not subject you to any adverse treatment. Responses will remain confidential within the Human Resources Department; and will be used only for the necessary information to include in our Affirmative Action Program and reporting requirements to the government. When reported, data will not identify any specific individuals.

What is your gender?MaleFemalePrefer not to disclose

What is your race/ethnicity? Please mark the one box that describes the race/ethnicity category with which you primarily identify.Hispanic or Latino: a person of Cuban, Mexican, Chicano, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race.White (Not Hispanic or Latino): a person having origins in any of the original peoples of Europe, the Middle East or North Africa.Black or African American (Not Hispanic or Latino): a person having origins in any of the black racial groups of Africa.Native Hawaiian or Other Pacific Islander (Not Hispanic or Latino): a person having origins in any of the peoples of Hawaii, Guam, Samoa or other Pacific Islands.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.American Indian or Alaska 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 maintains tribal affiliation or community attachment.Two or more races (Not Hispanic or Latino): All persons who identify with more than one of the above five races.Prefer not to disclose

To sign this document, please enter 'agree' and digitally sign:

Type 'agree' to confirm *0 / 5

Certification and Electronic Signature *I certify that I am the person identified in this questionnaire and that all information and supporting documents I have submitted are true, accurate, complete, and not misleading as of the date signed. I have reviewed my responses and had the opportunity to correct them before signing.

I understand that Prisma International Corporation and its affiliated companies may rely on the information provided when evaluating my enrollment, qualifications, onboarding, eligibility for assignments, and contractor relationship. I understand that any material false statement, misrepresentation, or omission may result in disqualification, suspension or withdrawal of assignments, or termination of the contractor relationship, subject to applicable law and any governing agreement.

By checking the acknowledgment box, entering or signing my name, and submitting this questionnaire, I confirm my intent to sign electronically. I consent to the use and retention of this electronic record and agree that my electronic signature has the same force and effect as my handwritten signature.I have read, understand, and agree to the Certification and Electronic Signature statement above.

E-Signature *

Your Name *

Date

ENROLLMENT FORM