T
EXT
FOR VOLUNTARY DEMOGRAPHIC INFORMATION - HP/SLIP 2013-2014
B
VOLUNTARY
DEMOGRAPHIC INFORMATION (Link
to one comprehensive Privacy Act Statement and Explanation on How
this Data is Used). Provision of this
information is voluntary. There are no adverse consequences if you
do not respond.
Disabilities Do
you have a disability (a physical or mental impairment which
substantially limits one or more major life activities)?
Yes
No
Decline to answer
The
Department of Justice is committed to promoting employment
opportunities for qualified individuals with disabilities, including
the targeted disabilities listed below. As part of this commitment,
from time to time the Department develops specific initiatives
designed to increase the hiring of qualified individuals with
targeted disabilities. If you are interested in being considered
for hiring under such an initiative, should one be in place while
your application is active, please indicate your interest and
consent below. If you do not identify your disability status at
this time, you may do so at any time during the hiring or employment
process; however, you will not be able to amend your HP/SLIP
application once you have submitted it. Disclosure of disability
status below will be treated as confidential and shared only with
DOJ officials involved in the hiring process. Disability
disclosures will not be reflected on your application and your
status will not be disclosed as part of the standard review and
selection process. I have a
targeted disability and am interested in being considered for the
HP/SLIP under any DOJ initiative designed to promote the hiring of
qualified individuals with targeted disabilities. I consent to the
disclosure of the fact that I have identified myself as an
individual with a targeted disability, along with my name, contact
information, and other information provided in this application to
DOJ officials involved in the hiring process. I understand that if
I am contacted pursuant to a specific initiative, I will be asked
to provide the documentation described in 5 C.F.R. §§
213.3102(u)(2)(ii) and (u)(iii).
Blindness
APPLY
(ALL
SECTIONS MANDATORY UNLESS OTHERWISE INDICATED) Information
and Instructions Eligibility
& Personal Information Demographic
Information (Voluntary) Military
Service & Veterans’ Preference
Non-Legal
Education (Undergraduate/Graduate) Legal
Education (JD / LLM) & Transcript Post-Law
School Activities Legal
Writing (SLIP Applicants only) Specific
Law School Classes (SLIP Applicants Only) Law
School Academic Achievement (SLIP Applicants Only) Practice
Area Interests (SLIP Applicants Only) Honors
and Awards Professional
Accomplishments Employment
& Resume Components/Offices
of Interest Essays
Additional
Information (Voluntary) References View
and Print Application
Total Deafness Missing
Extremities Complete
Paralysis Partial
Paralysis Severe
Intellectual Disability Psychiatric
Disability / Retardation Epilepsy Dwarfism My Disability
is not one of those listed Decline to
answer. Gender
Male
Female
Decline to answer
Sexual
Orientation and Gender Identity Select
all that apply. Do you consider
yourself to be: Heterosexual
or straight Gay or Lesbian Bisexual Transgender Other Decline to
Answer
Ethnicity Are you Hispanic or
Latino (a person of Cuban, Mexican, Puerto Rican, South or Central
American, or other Spanish culture or origin, regardless of race)?
Yes
No
Decline to answer
Race and
National Origin Identification Select the racial
category or categories with which you most closely identify by
checking the boxes. For equal opportunity reporting purposes, data
is aggregated – if you check more than one box, you will be
reported in the category “Two or More Races.”) American
Indian Definition
Or Alaska Native Asian Definition Black or
African Definition
American
Native
Hawaiian Definition
Or Other Pacific
Islander White Definition Decline to
Answer
| File Type | application/msword |
| Author | dwillis |
| Last Modified By | Lynn Murray |
| File Modified | 2013-05-16 |
| File Created | 2013-05-16 |