Form FCC Form 396-A FCC Form 396-A Broadcast Equal Employment Opportunity Model Program Rep

Federal Communications Commission
Washington, D. C. 20554

Not approved by OMB
3060-0113

BROADCAST EQUAL EMPLOYMENT OPPORTUNITY
MODEL PROGRAM REPORT
Legal Name of the Applicant
Mailing Address
City

State or Country (if foreign address)

Telephone Number (include area code)

E-Mail Address (if available)
Facility ID Number

ZIP Code

Call Sign

Application for Construction Permit for New Station

Application for Assignment of License

Application for Transfer of Control
a. Service Type:

AM

b. Community of License:

City

FM

TV

Other (specify)
State

INSTRUCTIONS
Applicants seeking authority to construct a new commercial, noncommercial or international broadcast station, applicants seeking
authority to obtain assignment of the construction permit or license of such a station, and applicants seeking authority to acquire
control of an entity holding such construction permit or license are required to afford equal employment opportunity to all qualified
persons and to refrain from discrimination in employment and related benefits on the basis of race, color, religion, national origin or
sex. See 47 C.F.R. Section 73.2080. Pursuant to these requirements, an applicant who proposes to employ five or more full-time
employees must establish a program designed to assure equal employment opportunity. This is submitted to the Commission as the
Model EEO Program. For purposes of this form, a station employment unit is a station or a group of commonly owned stations in
the same market that share at least one employee.
Guidelines for a Model EEO Program and a Model EEO Program are attached.
NOTE: Check appropriate box, sign the certification below and return to FCC:
Station employment unit will employ fewer than 5 full-time employees; therefore no written program is being submitted.
Station employment unit will employ 5 or more full-time employees. Our Model EEO Program is attached. (You must

I certify that the statements made herein are true, complete, and correct to the best of my knowledge and belief, and are made in
Signed

Name of Respondent

Title

Date

WILLFUL FALSE STATEMENTS ON THIS FORM ARE PUNISHABLE BY FINE AND/OR IMPRISONMENT
(U.S. CODE, TITLE 18, SECTION 1001), AND/OR REVOCATION OF ANY STATION LICENSE OR CONSTRUCTION PERMIT
(U.S. CODE, TITLE 47, SECTION 312(a)(1)), AND/OR FORFEITURE (U.S. CODE, TITLE 47, SECTION 503).

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GUIDELINES TO THE MODEL EEO PROGRAM
The model EEO program adopted by the Commission for construction permit applicants, assignees, and transferees contains five
sections designed to assist the applicant in establishing an effective EEO program for its station. The specific elements which
should be addressed are as follows:
I. GENERAL POLICY
The first section of the program should contain a statement by the applicant that it will afford equal employment opportunity in all
personnel actions without regard to race, color, religion, national origin or sex, and that it has adopted an EEO program which is
designed to fully utilize the skills of qualified persons.
II. RESPONSIBILITY FOR IMPLEMENTATION
This section calls for the name (if known) and title of the official who will be designated by the applicant to have responsibility for
implementing the station's program.
III. POLICY DISSEMINATION
The purpose of this section is to disclose the manner in which the station's EEO policy will be communicated to employees and
prospective employees. The applicant's program should indicate whether it: (a) intends to utilize an employment application form
which contains a notice informing job applicants that discrimination is prohibited and that persons who believe that they have been
discriminated against may notify appropriate governmental agencies; (b) will post a notice which informs job applicants and
employees that the applicant is an equal opportunity employer and that they may notify appropriate governmental authorities if they
believe that they have been discriminated against; and (c) will seek the cooperation of labor unions, if represented at the station, in
the implementation of its EEO program and in the inclusion of nondiscrimination provisions in union contracts. The applicant
should also set forth any other methods it proposes to utilize in conveying its EEO policy (e.g., orientation materials, on-air
announcements, station newsletter) to employees and prospective employees.
IV. RECRUITMENT
The applicant should specify the recruitment sources and other techniques it proposes to use to attract qualified job applicants. The
purpose of the listing is to assist the applicant in developing specialized referral sources to ensure wide dissemination of vacancy
information as job opportunities occur. Sources which subsequently prove to be nonproductive should not be relied on and new
sources should be sought.
MODEL EQUAL EMPLOYMENT OPPORTUNITY PROGRAM
I. GENERAL POLICY
It will be our policy to provide equal employment opportunity to all qualified individuals without regard to race, color, religion,
national origin or sex in all personnel actions including recruitment, evaluation, selection, promotion, compensation, training and
termination.

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It will also be our policy to promote the realization of equal employment opportunity through a positive, continuing program of
specific practices designed to ensure the full realization of equal employment opportunity without regard to race, color, religion,
national origin or sex.
To make this policy effective, and to ensure conformance with the Rules and Regulations of the Federal Communications
Commission, we have adopted an Equal Employment Opportunity Program which includes the following elements:
II. RESPONSIBILITY FOR IMPLEMENTATION
Name/Title
will be responsible for the administration and implementation of our Equal Employment Opportunity Program. It will also
be the responsibility of all persons making employment decisions with respect to the recruitment, evaluation, selection,
promotion, compensation, training and termination of employees to ensure that our policy and program is adhered to and
that no person is discriminated against in employment because of race, color, religion, national origin or sex.
III. POLICY DISSEMINATION
To ensure that all members of the staff are cognizant of our equal employment opportunity policy and their individual
responsibilities in carrying out this policy, the following communication efforts will be made:
The station's employment application forms will contain a notice informing prospective employees that discrimination because
of race, color, religion, national origin or sex is prohibited and that they may notify the appropriate local, State or Federal
agency if they believe they have been the victims of discrimination.
Appropriate notices will be posted informing applicants and employees that the station is an Equal Opportunity Employer and
of their right to notify an appropriate local, State or Federal agency if they believe they have been the victims of
discrimination.
We will seek the cooperation of unions, if represented at the station, to help implement our EEO program and all union
contracts will contain a nondiscrimination clause.
Other (specify)

IV. RECRUITMENT
To ensure that information concerning each full-time vacancy is widely disseminated, we propose to use the following list of
recruitment sources consistent with the requirements of 47 C.F.R. Section 73.2080:

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FCC NOTICE REQUIRED BY THE PAPERWORK REDUCTION ACT
We have estimated that each response to this collection of information will take one (1) hour. Our estimate includes the time to read
the instructions, look through existing records, gather and maintain required data, and actually complete and review the form or
response. If you have any comments on this estimate, or on how we can improve the collection and reduce the burden it causes you,
please write the Federal Communications Commission, AMD-PERM, Paperwork Reduction Project (3060-0113), Washington, D.
C. 20554. We will also accept your comments via the Internet if you send them to [email protected]. Remember - you are not required
to respond to a collection of information sponsored by the Federal government, and the government may not conduct or sponsor this
collection, unless it displays a currently valid OMB control number or if we fail to provide you with this notice. This collection has
been assigned an OMB control number of 3060-0113.
THE FOREGOING NOTICE IS REQUIRED BY THE PAPERWORK REDUCTION ACT OF 1995, P.L. 104-13,
OCTOBER 1, 1995, 44 U.S.C. 3507.

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