Voluntary Demographic Form

T EXT FOR VOLUNTARY DEMOGRAPHIC INFORMATION - HP/SLIP 2013-2014

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VOLUNTARY DEMOGRAPHIC INFORMATION

(Link to one comprehensive Privacy Act Statement and Explanation on How this Data is Used).

Provision of this information is voluntary. There are no adverse consequences if you do not respond.

Disabilities

Do you have a disability (a physical or mental impairment which substantially limits one or more major life activities)?

• Yes

• No

• Decline to answer

The Department of Justice is committed to promoting employment opportunities for qualified individuals with disabilities, including the targeted disabilities listed below. As part of this commitment, from time to time the Department develops specific initiatives designed to increase the hiring of qualified individuals with targeted disabilities. If you are interested in being considered for hiring under such an initiative, should one be in place while your application is active, please indicate your interest and consent below. If you do not identify your disability status at this time, you may do so at any time during the hiring or employment process; however, you will not be able to amend your HP/SLIP application once you have submitted it. Disclosure of disability status below will be treated as confidential and shared only with DOJ officials involved in the hiring process. Disability disclosures will not be reflected on your application and your status will not be disclosed as part of the standard review and selection process.

• I have a targeted disability and am interested in being considered for the HP/SLIP under any DOJ initiative designed to promote the hiring of qualified individuals with targeted disabilities. I consent to the disclosure of the fact that I have identified myself as an individual with a targeted disability, along with my name, contact information, and other information provided in this application to DOJ officials involved in the hiring process. I understand that if I am contacted pursuant to a specific initiative, I will be asked to provide the documentation described in 5 C.F.R. §§ 213.3102(u)(2)(ii) and (u)(iii).

• Blindness

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APPLY

(ALL SECTIONS MANDATORY UNLESS OTHERWISE INDICATED)

Information and Instructions

Eligibility & Personal Information

Demographic Information (Voluntary)

Military Service & Veterans’ Preference

Non-Legal Education (Undergraduate/Graduate)

Legal Education (JD / LLM) & Transcript

Post-Law School Activities

Legal Writing (SLIP Applicants only)

Specific Law School Classes (SLIP Applicants Only)

Law School Academic Achievement (SLIP Applicants Only)

Practice Area Interests (SLIP Applicants Only)

Honors and Awards

Professional Accomplishments

Employment & Resume

Components/Offices of Interest

Essays

Additional Information (Voluntary)

References

View and Print Application

• Total Deafness

• Missing Extremities

• Complete Paralysis

• Partial Paralysis

• Severe Intellectual Disability

• Psychiatric Disability / Retardation

• Epilepsy

• Dwarfism

• My Disability is not one of those listed

• Decline to answer.

Gender

• Male

• Female

• Decline to answer

Sexual Orientation and Gender Identity Select all that apply.

Do you consider yourself to be:

• Heterosexual or straight

• Gay or Lesbian

• Bisexual

• Transgender

• Other

• Decline to Answer

Ethnicity

Are you 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

• Decline to answer

Race and National Origin Identification

Select the racial category or categories with which you most closely identify by checking the boxes. For equal opportunity reporting purposes, data is aggregated – if you check more than one box, you will be reported in the category “Two or More Races.”)

• American Indian Definition

Or Alaska Native

• Asian Definition

• Black or African Definition American

• Native Hawaiian Definition

Or Other Pacific

Islander

• White Definition

• Decline to Answer