WHYY Applicant Survey

This applicant survey will be separated from your application. The survey information will be kept confidential, used only for computerized statistical reports and other lawful uses.

Please note, this survey is NOT a job application. If you complete this survey you MUST still submit a resume as described here.

First Name:

Middle:

Last Name:

Mailing Address:

City:

State:

Zip:

Email:

Job Applied For:

Referral Source- How did you FIRST learn of this position?

1. Age 18 or older. (Please leave blank if under the age of 18.)

2. Male Female

3. RACE/ETHNIC IDENTIFICATION — PLEASE CHECK ALL THAT APPLY

Are you of 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

SELECT ONE OR MORE OF THE FOLLOWING RACIAL CATEGORIES:

American Indian or Alaska Native (A person having origins in any of the original peoples of North or South America, including Central America, and who maintains tribal affiliations or community attachment.

Asian (A person having origin in any of the original peoples of the Far East, Southwest Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.

Black or African American (A person having origins in any of the black racial groups of Africa.)

Native Hawaiian or other Pacific Islander (A person having origins in the original peoples of Hawaii, Guam, Samoa, or other Pacific islands.)

White (A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.)

4. MILITARY STATUS- Please check the one box that best describes your military status.

No Military Service Active Reserve Inactive Reserve Retired
Vietnam Veteran Other Veteran Disabled Veteran