Application: Special Order Designer I Job at DeZURIK, Inc. in Sartell, MN

Dezurik is an Affirmative Action/Equal Opportunity Employer and as such, we are required to collect and maintain information related to applicants and employees in order to meet governmental recordkeeping and reporting requirements and to monitor the effectiveness of our outreach, recruitment and other employment practices. The information in this section will only be used in accordance with the provisions of applicable laws, executive order, and regulations. Providing the information is voluntary and refusal will not impact your application.

Q1. Voluntary Self-identification Survey – Ethnicity/Race (Part 1 of 2)

This company is an Equal Opportunity Employer/Disabled/VETS/Affirmative Action Employer. This survey is meant to help the company fulfill objectives in its affirmative action plans.

Please note that you are not required to complete this survey. Provision of this information is voluntary. The decision not to complete this survey will not affect any opportunity for employment or any benefits with the company. Any information you provide in this survey will be kept confidential and will not be used in any way that may adversely affect your employment with this company.

ETHNICITY (Please select the appropriate box)

Hispanic (A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race.)
Not Hispanic
Decline to Answer

Q2. Voluntary Self-identification Survey – Ethnicity/Race (Part 2 of 2)

This company is an Equal Opportunity Employer/Disabled/VETS/Affirmative Action Employer. This survey is meant to help the company fulfill objectives in its affirmative action plans.

Please note that you are not required to complete this survey. Provision of this information is voluntary. The decision not to complete this survey will not affect any opportunity for employment or any benefits with the company. Any information you provide in this survey will be kept confidential and will not be used in any way that may adversely affect your employment with this company.

RACE (If you checked "Not Hispanic" in Part 1 above, please check one or more of the boxes below.)

White (A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.)
Black/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 any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.)
Asian/Indian Subcontinent (A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.)

Q3. Voluntary Self-identification Survey – Gender

This company is an Equal Opportunity Employer/Disabled/VETS/Affirmative Action Employer. This survey is meant to help the company fulfill objectives in its affirmative action plans.

Please note that you are not required to complete this survey. Provision of this information is voluntary. The decision not to complete this survey will not affect any opportunity for employment or any benefits with the company. Any information you provide in this survey will be kept confidential and will not be used in any way that may adversely affect your employment with this company.

GENDER (Please select the appropriate box)

Male
Female
Decline to Answer

Q4. The following list identifies protected veterans. Indicate below if you are a protected veteran.

1. Disabled veterans;
2. Recently separated veterans;
3. Active duty wartime or campaign badge veterans; and
4. Armed Forces service medal veterans

These classifications are defined as follows:

A ‘‘disabled veteran’’ is one of the following: a veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans affairs; or a person who was discharged or released from active duty because of a service-connected disability.

A ‘‘recently separated veteran’’ means any veteran during the three-year period beginning on the date of such veteran’s discharge or release from active duty in the U.S. military, ground, naval, or air service.

An ‘‘active duty wartime or campaign badge veteran’’ means a veteran who served on active duty in the U.S. military, ground, naval or air service during a war, or in a campaign or expedition for which a campaign badge has been authorized under the laws administered by the Department of Defense.

An ‘‘Armed forces service medal veteran’’ means a veteran who, while serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985.

Protected veterans may have additional rights under USERRA—the Uniformed Services Employment and Reemployment Rights Act. In particular, if you were absent from employment in order to perform service in the uniformed service, you may be entitled to be reemployed by your employer in the position you would have obtained with reasonable certainty if not for the absence due to service. For more information, call the U.S. Department of Labor’s Veterans Employment and Training Service (VETS), toll-free, at 1–866–4–USA–DOL.

If you believe you belong to any of the categories of protected veterans listed above, please indicate by checking the appropriate box below. As a Government contractor subject to VEVRAA, we request this information in order to measure the effectiveness of the outreach and positive recruitment efforts we undertake pursuant to VEVRAA.

I identify as one or more of the classifications of protected veteran listed above
I am not a protected veteran
I don't wish to answer

Q5. Why are you being asked to complete this form?

Because we do work with the government, we must reach out to hire, and provide equal opportunity to qualified people with disabilities. To help us measure how well we are doing, we are asking you to tell us if you have a disability or if you ever had a disability.

Identifying yourself as an individual with a disability is voluntary, and we hope that you will choose to do so. Your answer
will be maintained confidentially and not be seen by selecting officials or anyone else involved in making personnel
decisions. Completing the form will not negatively impact you in any way, regardless of whether you have self-identified in
the past.
How do you know if 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. Disabilities
include, but are not limited to:

* Autism

* Cerebral palsy

* Gastrointestinal disorders, for example, Crohn's Disease, or irritable bowel syndrome

* Autoimmune disorder, for example, lupus, fibromyalgia, rheumatoid arthritis, or HIV/AIDS

* Deaf or hard of hearing

* Intellectual disability

* Blind or low vision

* Depression or anxiety

* Missing limbs or partially missing limbs

* Cancer

* Diabetes

* Nervous system condition for example, migraine headaches, Parkinson’s disease, or Multiple sclerosis (MS)

* Cardiovascular or heart disease

* Epilepsy

* Psychiatric condition, for example, bipolar disorder, schizophrenia, PTSD, or major depression

* Celiac disease

PUBLIC BURDEN STATEMENT: According to the Paperwork Reduction Act of 1995 no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. This survey should take about 5 minutes to complete.

Please check one of the boxes below:

Yes, I Have A Disability, Or Have A History/Record Of Having A Disability
No, I Don’t Have A Disability, Or A History/Record Of Having A Disability
I Don’t Wish To Answer