EEO - North Charleston Sewer District

Gender*

Male
Female

Age*

Name*

First Middle Last

Position(s) applied for*

Where did you learn about the job opening? NCSD Website, Newspaper Ad, Employment website, Job Service, Walk-in, Job Fair, District employee.

Check one if applicable:

Disabled Individual
Disabled Veteran / Vietnam Veteran

Please identify your Race/Ethnic Data by checking one category below: (Note: If identifying yourself as two or more races or ethnic groups, please only check the category two or more races below).

African American or Black (Not Hispanic or Latino)
A person having origins in any of the black racial groups of Africa.
American Indian or Alaskan Native
A person having origins in any of the original peoples of North and South America (including Central America), and who maintain tribal affiliation or community attachment.
Asian or Pacific Islander
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.
Hispanic or Latino
A person having origins of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish Culture or origin regardless of race.
White or Caucasian (Not Hispanic or Latino)
A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.
Other Pacific Islander or Native Hawaiian (Not Hispanic or Latino)
A person having origins in any of the peoples of Hawaii, Guam, Samoa, or other Pacific Islands.
Two or more races.
I do not wish to enter voluntary self-identification EEOC information on this form.

Signature*

Date

NOTICE TO INDIVIDUALS WITH DISABILITIES, DISABLED VETERANS AND VIETNAM ERA VETERANS Federal government contractors are subject to Section 403 of the Vietnam Era Veterans Readjustment Act of 1974 which requires that they take affirmative action to employ and advance in employment qualified disabled veterans of the Vietnam Era; and section 503 of the Rehabilitation Act of 1973, as amended, which requires the same of qualified disabled individuals. If you are a disabled veteran or have a physical or mental disability, you are invited to volunteer that information. The reason is to provide information regarding proper placement and appropriate accommodation to enable you to perform the essential functions of the position in a proper and safe manner. The information will not adversely affect any consideration for employment at the North Charleston Sewer District. If you wish to be identified, sign here:

Disabilities, Disabled Veterans, Vietnam Era Veterans - Signature

Thank you for submitting your job application!

EEO Information

EEO Information Form