Personal Data Form

The Equal Employment Opportunity Commission (EEOC) requires all private employers with 100 or more employees as well as federal contractors and first-tier subcontractors with 50 or more employees complete an EEO-1 report each year. Covered employers must invite employees to self-identify gender and race for this report.

If you choose not to self-identify at this time, the federal government requires Saint Mary’s College of California to determine this information by visual survey and/or other available information.


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Email *
Legal First Name
 *
Legal Last Name *
Chosen First and/or Last Name 
Emergency Contact Name *
Emergency Contact Phone Number *
Emergency Contact Relationship

Mark only one.
Clear selection
To authorize release of your phone number and/or address to students, faculty, or staff, indicate below.

Mark only one.
 *
U.S. Citizen?


 *
If you answered no to the previous question, please provide the name of the country that you are a citizen of:
Are you Hispanic or Latino?

Mark only one.
 *
(Needed for EEO-1 reporting)

Regardless of your answers to the prior questions, please check one or more of the following groups that you consider yourself to be a member:

Check all that apply.
 *
Required
If applicable, please select the appropriate veteran status below.
 *
Required
If applicable, please select below if you are disabled.
 *
Sex assigned at birth:
Clear selection
Gender Identity

Mark only one.
Clear selection
Personal Pronoun 

Mark only one.
Sexual Orientation

Mark only one.
Marital Status

Mark only one.
Carefully review the information provided below. If you are able to access this information electronically, find it satisfactory, and agree to the Electronic Record and Signature Disclosure (ERSD), please confirm your agreement by selecting the checkbox labeled 'I agree to use electronic records and signatures'
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Required
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