Voluntary Data Questionnaire

This county is an equal opportunity employer. This data questionnaire will help us to see how well we are doing in recruiting and selecting employee without regard to race, religion, sex, age, national origin or handicap.

THIS INFORMATION IS CONFIDENTIAL AND WILL NOT BE USED IN CONNECTION WITH YOUR JOB APPLICATION. THIS QUESTIONNAIRE WILL BE USED ONLY TO PROVIDE STATISTICS ON OUR PERSONNEL PROCESSES. Not required to fill out this section.

Position applied for:
1. What sex are you?
2. What is your age?
3. Of the following, of which racial/ethnic group do you consider yourself a member?
4. Are you currently, or have you within the past 12 months, been enrolled in a training institution (college, university, manpower training program, vocational or technical school, adult education program etc. )
5. How did you learn about the job for which you are applying
IMPORTANT FACTS ABOUT INFORMATION ON YOU APPLICATION This application is to assist in the hiring process. Certain information requested is private, that is, it may be released only to you or to agencies where you may be considered for employment.
PRIVATE DATA	WHY WE ASK FOR IT	DO YOU NEED TO PROVIDE IT LEGALLY?	WHAT MAY HAPPEN IF YOU DON’T PROVIDE IT
Social Security Number	Computer tracking, distinguish you from other applicants, make processing more efficient.	NO	May not be able to consider you for positions in which you are interested. It helps to ensure that we do not confuse your record with others.
Name	Distinguish you from other applicants.	YES	Failure may cause rejection of your application
Address	Send employment information & others notices.	NO	Failure will cause non-receipt notices and employment information.
Home Telephone (or message)	Contact you to determine availability of interview	NO	May not be able to employ you in jobs, which require you to come to work on short notice. May cause delay in evaluating your application and may have a negative impact on your securing a position on short notice.
Veteran Status, Sex, Age, Racial/Ethnic Group	Make equal opportunity reports as required by law and provide affirmative action in service.	NO	May not be able to determine if our selection processes result in unfair discrimination, or to take affirmative action in our hiring.
Conviction Record	Determine if we may legally accept an application from you and determine if your record may be job related.	YES	We will not be able to make determinations required by law.