This form is kept seperate from your application. It is for governmental reporting requirements only. The Federal Government requires us to collect the following statistics to ensure that we are following the Equal Opportunity Guidelines. The information will be kept confidential and seperate. It will not be used in connection with your name, your application, or any test that you take.

Submission of this is voluntary. If you choose not to answer any of the questions, you will not be penalized.

Please put a check mark by each of the following that applies to you.