Self-Identification Survey
PEN/Faulkner is an affirmative action/equal opportunity employer, and strongly encourages persons of color, women, LGBTQIA persons, and persons with disabilities to apply. For this reason, we invite you to provide the information below to help us gauge how well we comply with the Equal Employment Opportunity Commission's standards.

Submission of this information will remain confidential and anonymous, and is not provided to the hiring manager for the position at any stage in the process.

Date of Application *
Gender Identity (check all that apply): *
Are you Hispanic or Latino/a/x? *
Race/Ethnicity Identification (check all that apply)
Are you a Veteran? *
HIGHEST Education Level of Parent/Guardian 1: *
HIGHEST Education Level of Parent/Guardian 2: *
Sexual Identity (check all that apply): *
What was the approximate combined income of your parental/guardian household before you reached age 18? *
Did your immediate family qualify for food stamps and/or did you qualify for free and reduced meals at any point during your childhood? *
What was the primary language spoken in your childhood home? *
Are you a veteran of the United States military (any branch)? *
About Disabilities
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: Blindness, Deafness, Cancer, Diabetes, Epilepsy, Autism, Cerebral palsy, HIV/AIDS, Schizophrenia, Muscular dystrophy, Bipolar disorder, Major depression, Multiple sclerosis (MS), Missing limbs or partially missing limbs, Post-traumatic stress disorder (PTSD), Obsessive compulsive disorder, Impairments requiring the use of a wheelchair, and Intellectual disability.
Do you have a disability? *
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