Self-Identification Form

Step 1 of 4

  • In order to comply with federal equal opportunity recordkeeping and other reporting requirements, PINE asks all applicants to provide us with certain demographic information. Providing this information is strictly voluntary and will be kept confidential and separate from any resumes or other material submitted. It will not be used in determining employment at PINE. If you prefer to have a printable PDF copy of this form, click here to download that.
  • PINE believes all persons are entitled to equal employment opportunities and does not discriminate against its employees or applicants for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, genetic information or any other characteristic protected by law.
  • IMPORTANT NOTE: COMPLETION OF THIS DATA IS VOLUNTARY AND WILL NOT AFFECT EMPLOYMENT DECISIONS OR SUBJECT YOU TO ANY ADVERSE TREATMENT.
  • RACE/ETHNIC DATA CLASSIFICATIONS
    In completing the Race/Ethnicity portion of the form, first indicate if you so identify yourself as Hispanic or Latino. If you do so identify yourself, you should stop at that point and go on to the next section regarding veteran status. If you do not identify as Hispanic or Latino, then check the appropriate box to identify the race/ethnicity with which you do identify. If you identify with two or more races, please check the “two or more race” box, and also list the single race/ethnic group with which you most identify.
    Please list the single race/ethnic group with which you most identify from the classifications provided above.
  • PUBLIC BURDEN STATEMENT: According to the Paperwork Reduction Act of 1995 no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. This survey should take about 5 minutes to complete.