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Position: Pro Bono Project Coordinator
Location: Chicago - Loop
Job Code: O89

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Equal Opportunity Questionnaire

As an equal opportunity employer, we hire without consideration to race, religion, creed, color, national origin, age, gender, gender identity, sexual orientation, marital status, veteran status or disability. We invite you to complete the optional self-identification fields below used for compliance with government regulations and record-keeping guidelines.


Voluntary Self-Identification of Veteran Status

This employer is a Government contractor subject to the Vietnam Era Veterans' Readjustment Assistance Act of 1974, as amended by the Jobs for Veterans Act of 2002, 38 U.S.C. 4212 (VEVRAA), which requires Government contractors to take affirmative action to employ and advance in employment:

  1. disabled Veterans
  2. recently separated Veterans
  3. active duty wartime or campaign badge Veterans
  4. Armed Forces service medal Veterans

These classifications are defined as follows:

  • A "disabled Veteran" is one of the following:
    • A Veteran of the U.S. military, ground, naval, or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs; or
    • a person who was discharged or released from active duty because of a service-connected disability.
  • A "recently separated Veteran" means any Veteran during the three-year period beginning on the date of such Veteran's discharge or release from active duty in the U.S. military, ground, naval or air service.
  • An "active duty wartime or campaign badge Veteran" means a Veteran who served on active duty in the U.S. military, ground, naval, or air services during a war, or in a campaign or expedition for which a campaign badge has been authorized under the laws administered by the Department of Defense.
  • An "Armed Forces service medal Veteran" means a Veteran who, while service on active duty in the U.S, military, ground, naval, or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985.

If you believe you belong to any of the categories of protected Veterans listed above, please indicate by making the appropriate selection below.  As a government contractor subject to VEVRAA, we request this information to measure the effectiveness of the outreach and positive recruitment efforts we undertake pursuant to VEVRAA.


Voluntary Self-Identification of Disability

Voluntary Self-Identification of Disability

Form CC-305   
OMB Control Number 1250-0005   
Expires 1/31/2020   

Why are you being asked to complete this form?

Because we do business with the government, we must reach out to, hire, and provide equal opportunity to qualified people with disabilities.i To help us measure how well we are doing, we are asking you to tell us if you have a disability or if you ever had a disability. Completing this form is voluntary, but we hope that you will choose to fill it out. If you are applying for a job, any answer you give will be kept private and will not be used against you in any way.

If you already work for us, your answer will not be used against you in any way. Because a person may become disabled at any time, we are required to ask all of our employees to update their information every five years. You may voluntarily self-identify as having a disability on this form without fear of any punishment because you did not identify as having a disability earlier.


How do I know if I have a disability?

You are considered to have a disability if you have a physical or mental impairment or medical condition that substantially limits a major life activity, or if you have a history or record of such an impairment or medical condition. Disabilities include, but are not limited to:

• Blindness• Cerebral palsy• Multiple sclerosis (MS)
• Deafness• HIV/AIDS• Missing limbs or partially missing limbs
• Cancer• Schizophrenia• Post-traumatic stress disorder (PTSD)
• Diabetes• Major depression• Obsessive compulsive disorder
• Epilepsy• Bipolar disorder• Impairments requiring the use of a wheelchair
• Autism• Muscular dystrophy• Intellectual disability (previously called mental retardation)
 

Please Select one of the options below :

   
 
Format: MM/DD/YYYY

Reasonable Accommodation Notice

Federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. Please tell us if you require a reasonable accommodation to apply for a job or to perform your job. Examples of reasonable accommodation include making a change to the application process or work procedures, providing documents in an alternate format, using a sign language interpreter, or using specialized equipment.
i Section 503 of the Rehabilitation Act of 1973, as amended. For more information about this form or the equal employment obligations of Federal contractors, visit the US. Department of Labor's Office of Federal Contract Compliance Programs (OFCCP) website at www.dol.gov/ofccp.
PUBLIC BURDEN STATEMENT: According to the Paperwork Reduction Act of 1995 no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. This survey should take about 5 minutes to complete.


Attestation and Electronic Signature

I certify the answers given herein are true and complete to the best of my knowledge, and I authorize the investigation of all statements contained within this employment application that may be necessary in arriving at an employment decision. I further understand that, in the event of my employment by the Agency, any false or misleading information given in my application or interview(s) may result in discharge. I also understand that if employed by the Agency, I will be required to abide by all Agency rules and regulations.

I understand this application and any subsequent offer of employment I may receive from the Agency does not, and is not intended to, create a contract of employment or any contractual rights in favor of the Agency or me beyond those existing in an “at will” employment relationship unless provided otherwise by an applicable collective bargaining agreement. I understand that any employment relationship which may arise between the Agency and me will be an “at will relationship,” which means the Agency reserves the right to change, modify, suspend, revoke, or terminate my employment at any time, with or without reason, and with or without notice, and that I likewise have the right to terminate my employment with the Agency at any time, with or without notice. I further understand no representative of the Agency, other than the President/Chief Executive Officer, has any authority to enter into any agreement for employment for any specified time, or to make any agreement contrary to the foregoing, and any such general or specific commitments must be in writing, in a document executed by the President/ Chief Executive Officer and me.

 

 
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