Voluntary Self-Identification (Veteran & Disability) Form

    VOLUNTARY SELF-IDENTIFICATION (VETERAN & DISABILITY) FORM


    We invite all applicants and employees to complete this voluntary self-identification form for protected veteran status and disability. Completing the form is optional, is not required to obtain employment, and will not result in any adverse treatment. Your responses are confidential, maintained separately from your application and personnel records, and used only as permitted by law for compliance and program reporting.


    Subject to the Far West, Inc. shareholder hire policy, all qualified applicants and employees receive equal consideration for opportunities without regard to disability, veteran status, or any other status protected by law. Questions about these requirements or this request may be directed to this office.

    Indicate Veteran status, if applicable:

    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

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