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United States Middle East

Location:
Roanoke, VA
Salary:
Negotiable
Posted:
April 16, 2024

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Voluntary Self Identification Form

Aramark’s policy provides equal employment opportunity to all employees and applicants for employment without regard to race, color, religion, national origin, age, sex, gender, pregnancy, disability, sexual orientation, gender identity, genetic information, military status, protected veteran status or other classification protected by applicable federal, state or local law. VARIOUS AGENCIES OF THE UNITED STATES GOVERNMENT REQUIRE EMPLOYERS TO COLLECT INFORMATION ON EMPLOYEES AND APPLICANTS. ARAMARK COLLECTS THIS INFORMATION TO COMPLY WITH THESE RECORDKEEPING REQUIREMENTS AND TO DETERMINE RECRUITING AND EMPLOYMENT PATTERNS. Providing the information is voluntary. This information will not be considered in making any employment-related decisions. This document and any other information collected during this process will be kept confidential.

For your reference:

• Hispanic or Latino: A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin regardless of race.

• White (Not Hispanic or Latino): A person having origins in any of the original peoples of Europe, the Middle East or North Africa.

• Black or African American (Not Hispanic or Latino): A person having origins in any of the black racial groups of Africa.

• Native Hawaiian or Pacific Islander (Not Hispanic or Latino): A person having origins in any of the peoples of Hawaii, Guam, Samoa or other Pacific Islands.

• Asian (Not Hispanic or Latino): 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.

• American Indian or Alaska Native: a person having origins in any of the original peoples of North and South America (including Central America), and who maintains tribal affiliation or community attachment.

• Two or more races (Not Hispanic or Latino): All persons who identify with more than one of the above five races.

• I do not wish to disclose.

American Indian/Alaskan Native/Indigenous

Asian

Black or African American

Native Hawaiian or Other Pacific Island

Two or More Races

White

I do not wish to provide this information

Race:

Hispanic or Latino

Not Hispanic or Latino

I do not wish to provide this information

Ethnicity:

VOLUNTARY SELF-IDENTIFICATION OF VETERAN STATUS

Why are you being asked to complete this form?

1. This employer is a Government contractor subject to the Vietnam Era Veterans' Readjustment Assistance Act of 1974, as amended by the Jobs for Veterans Act of 2002, 38 U.S.C. 4212 (VEVRAA), which requires Government contractors to take affirmative action to employ and advance in employment: (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:

o 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 o 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. 2. 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.

3. Submission of this information is voluntary and refusal to provide it will not subject you to any adverse treatment. The information provided will be used only in ways that are not inconsistent with the Vietnam Era Veterans' Readjustment Assistance Act of 1974, as amended. 4. The information you submit will be kept confidential, except that (i) supervisors and managers may be informed regarding restrictions on the work or duties of disabled veterans, and regarding necessary accommodations; (ii) first aid and safety personnel may be informed, when and to the extent appropriate, if you have a condition that might require emergency treatment; and (iii) Government officials engaged in enforcing laws administered by the Office of Federal Contract Compliance Programs, or enforcing the Americans with Disabilities Act, may be informed.

I IDENTIFY AS ONE OR MORE OF THE CLASSIFICATIONS OF PROTECTED VETERAN LISTED ABOVE

I AM A VETERAN, BUT I DO NOT MEET THE PROTECTED VETERAN DEFINITION

I AM NOT A VETERAN

I DO NOT WISH TO ANSWER

Voluntary Self-Identification of Disability

Form CC-305

Page 1 of 1

OMB Control Number 1250-0005

Expires 04/30/2026

Name: Date:

Employee ID:

(if applicable)

Why are you being asked to complete this form?

We are a federal contractor or subcontractor. The law requires us to provide equal employment opportunity to qualified people with disabilities. We have a goal of having at least 7% of our workers as people with disabilities. The law says we must measure our progress towards this goal. To do this, we must ask applicants and employees if they have a disability or have ever had one. People can become disabled, so we need to ask this question at least every five years. Completing this form is voluntary, and we hope that you will choose to do so. Your answer is confidential. No one who makes hiring decisions will see it. Your decision to complete the form and your answer will not harm you in any way. If you want to learn more about the law or this form, visit the U.S. Department of Labor’s Office of Federal Contract Compliance Programs (OFCCP) website at

www.dol.gov/ofccp.

How do you know if you have a disability?

A disability is a condition that substantially limits one or more of your “major life activities.” If you have or have ever had such a condition, you are a person with a disability. Disabilities include, but are not limited to:

• Alcohol or other substance use disorder

(not currently using drugs illegally)

• Autoimmune disorder, for example,

lupus, fibromyalgia, rheumatoid arthritis,

HIV/AIDS

• Blind or low vision

• Cancer (past or present)

• Cardiovascular or heart disease

• Celiac disease

• Cerebral palsy

• Deaf or serious difficulty hearing

• Diabetes

• Disfigurement, for example,

disfigurement caused by burns,

wounds, accidents, or congenital

disorders

• Epilepsy or other seizure disorder

• Gastrointestinal disorders, for example,

Crohn's Disease, irritable bowel

syndrome

• Intellectual or developmental disability

• Mental health conditions, for example,

depression, bipolar disorder, anxiety

disorder, schizophrenia, PTSD

• Missing limbs or partially missing limbs

• Mobility impairment, benefiting from the

use of a wheelchair, scooter, walker,

leg brace(s) and/or other supports

• Nervous system condition, for

example, migraine headaches,

Parkinson’s disease, multiple sclerosis

(MS)

• Neurodivergence, for example,

attention-deficit/hyperactivity disorder

(ADHD), autism spectrum disorder,

dyslexia, dyspraxia, other learning

disabilities

• Partial or complete paralysis (any

cause)

• Pulmonary or respiratory conditions,

for example, tuberculosis, asthma,

emphysema

• Short stature (dwarfism)

• Traumatic brain injury

Please check one of the boxes below:

Yes, I have a disability, or have had one in the past

No, I do not have a disability, and have not had one in the past

I do not wish to answer

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.

For Employer Use Only

Employers may modify this section of the form as needed for recordkeeping purposes. For example:

Job Title: Date of Hire: Employee Signature:

Electronically signed by:

Tiona Burwell



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