Voluntary Self Identification Form - Office of Inspector General

Voluntary Self‐Identification

Your Privacy Is Protected

This information is only used to determine if our recruitment efforts are reaching all segments of the population, consistent with Federal equal employment opportunity laws. Any responses are voluntary and will be treated in a highly confidential manner. Your responses are not released to the panel rating the applications, to the selecting official, or to anyone else who can affect your application. No information taken from this form is ever placed in your Applicant or Personnel file. This information will not be used for any employment, compensation, promotions or transfer opportunity decisions or other conditions of employment. This is vital information not available from any other source. We can only get it directly from you. Thank you for helping us to provide better service.

Name*

First Last

Select the position(s) you applied for:*

Gender*

Female
Male

Race*

White not of Hispanic Origin. A person having origins in any of the original peoples of Europe, North Africa or the Middle East.
Black or African American. A person having origins in any of the black racial groups of Africa.
American or Alaska Native. A person having origins in any of the original peoples of North or South America (including Central America), and who maintains cultural identification through tribal affiliation or community.
Asian. A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, or Vietnam.
Hispanic or Latino. A person of Mexican, Puerto Rican, Cuban, Central or South American, or other Spanish Culture or origin, regardless of race.
Native Hawaiian or Other Pacific Islander. A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific islands.

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