EEO Self-Identification Form (Remote Employees)
Full Name
Work Email
Job Title
Gender
Female
Male
Non-Binary
Decline to Self-Identify
Ethnicity
Hispanic or Latino
Not Hispanic or Latino
Decline to Self-Identify
Race
White
Black or African American
Asian
American Indian or Alaska Native
Native Hawaiian or Other Pacific Islander
Two or More Races
Decline to Self-Identify
Disability Status
Yes, I have a disability
No, I do not have a disability
Decline to Self-Identify
Veteran Status
I am a Veteran
I am not a Veteran
Decline to Self-Identify
Remote Work Location (City, State/Country)