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TO ALL APPLICANTS <br />The information requested in the following questions will not affect you as an applicant. <br />The information will be used to gather statistics to complete reports, track the status of <br />the Affirmative Action Plan for the City of Ramsey and to determine how effective our <br />recruitment efforts are. We would appreciate your assistance in our efforts to ensure <br />equal employment opportunity. <br />Providing this information is STRICTLY VOLUNTARY. <br />Title of position for which applying: <br />City and State in which you reside: <br />Your age: Your sex: <br />What Race /Ethnic group do you consider yourself? <br />American Indian or Alaskan Native Asian and Pacific Islanders <br />Black <br />If yes, please identify: <br />CITY OF RAMSEY <br />APPLICANT SURVEY <br />Caucasian Hispanic <br />Do you have a disability? Yes No <br />If you wish to identify your veteran status, please complete: <br />Disabled Veteran Vietnam Era Veteran <br />Referral Source: Ad (please specify) <br />Ramsey Employee Job Service School <br />Other source: <br />Failure to provide this information will not jeopardize or adversely affect your <br />consideration for employment. This information will not be used in the selection process <br />for employment. Upon receipt by the City, this form will be kept in a confidential file <br />separate from your application. <br />G:\ Administration \HumanResources\Recruitment \Forms \Application Packet <br />Forms\Application Packet Forms (Times New Roman) \(08) Applicant Survey.doc <br />