Staff Accountant - Diversity Talent Scouts

Completion of this form is voluntary and will not affect your opportunity for employment, or the terms or conditions of your employment. This form will be used for EEO-1 reporting purposes only and will be kept separate from all other personnel records only accessed by the Human Resources department. Please return completed forms to the HR department. If you choose not to self-identify your race/ethnicity at this time, the federal government requires diversitytalentscouts.com to determine this information by visual survey and/or other available information.

NAME

JOB TITLE

DATE COMPLETED

GENDER

Male
Female

RACE/ETHNICITY: (Please check one of the descriptions below corresponding to the ethnic group with which you identify.)

Hispanic or Latino: A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin regardless of race.
Hispanic or Latino: A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin regardless of race.
White (Not Hispanic or Latino): A person having origins in any of the original peoples of Europe, the Middle East or North Africa.
Black or African American (Not Hispanic or Latino): A person having origins in any of the black racial groups of Africa.
Native Hawaiian or Pacific Islander (Not Hispanic or Latino): A person having origins in any of the peoples of Hawaii, Guam, Samoa or other Pacific Islands.
Asian (Not Hispanic or Latino): 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
Native American or Alaska Native (Not Hispanic or Latino): A person having origins in any of the original peoples of North and South America (including Central America) and who maintains tribal affiliation or community attachment.
Two or more races (Not Hispanic or Latino): All persons who identify with more than one of the above five races.
I do not wish to disclose.

I may receive phone/text communications about career opportunities, interviews, job offers, and other related information from Diversity Talent Scouts (+1 (980) 890-4336, +1 (704) 318-2841, +1 (980) 705-9967 or +1 (704) 285-0604) (Message and data rates may apply, message frequency varies). I may receive emails from dtsrecruit.com. I can opt-out at any time by unsubscribing or texting STOP. My data will be handled in accordance with the privacy policy. Terms of service: https://loxo.co/legal/master-subscription-terms-of-service-agreement. For help, email support@loxo.co.

Work Authorization

Do You Require Visa Sponsorship?

Pronouns

Voluntary Self Identification