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CORTAC Group: Voluntary Self-Identification Survey

We invite you to complete this optional survey to help us evaluate our diversity and inclusion efforts. Submission of the information on this form is strictly voluntary and refusal to provide it will not subject you to any adverse treatment or affect your job application. Information obtained will be kept separate from your name or job application. This information will be kept secure and confidential and will be used solely to evaluate our diversity and inclusion efforts.

• What ethnicity do you identify as?

  (Please select all that apply)

  • White / Caucasian
  • Hispanic, Latino, or Spanish origin
  • Black or African American
  • Asian
  • Native Hawaiian or other Pacific Islander
  • Indigenous Peoples, First Nations, Native American, or Alaska Native
  • Middle Eastern or North African
  • Other (Not Listed)
  • I decline to say
• What gender do you identify as?
  • Female
  • Male
  • Non-binary
  • Other (Not Listed)
  • I decline to answer
• Are you a protected veteran? This can be defined by meeting one or more of the following criteria: Recently separated veteran, disabled veteran, active-duty wartime or campaign badge veteran, and/or Armed Forces service medal veteran?
  • Yes
  • No
  • I decline to answer
• Do you 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.)
  • Yes (I have a disability or previously had a disability)
  • No, I do not have a disability
  • I decline to answer