Voluntary Self-identification - EEO Status
Marton Technologies, Inc. is an Equal Opportunity Employer and is committed to providing equal opportunity in all employment practices, including but not limited to: selection, hiring, promotion, transfer and compensation to all qualified applicants and employees without regard to age, race, color, creed, national origin, sex, religion, genetic information, disability, ancestry, marital status, veteran status, or any other category protected by law.
Marton Technologies, Inc. is subject to certain governmental record keeping and reporting requirements for the administration of civil rights laws and regulations. In order to comply with these laws, Marton Technologies, Inc. invites applicants to voluntarily self-identify their gender and race or ethnicity. Submission of this information is voluntary and refusal to provide it will not subject you to any adverse treatment. The information obtained will be kept confidential and may only be used in accordance with the provisions of applicable laws, executive orders, and regulations, including those that require the information to be summarized and reported to the federal government for civil rights enforcement. When reported, data will not identify any specific individual.
Voluntary Self-identification - Veteran Status
Protected Veteran Types and Definitions
A protected veteran is a veteran who is protected under the nondiscrimination and affirmative action provisions of the Vietnam Veterans' Readjustment Assistance Act, 38 U.S.C. 4212; specifically a veteran who may be classified as an active duty wartime or campaign badge veteran, disabled veteran, Armed Forces service medal veteran, or recently separated veteran.
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.
Armed Forces Service Medal Veteran – means any 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 (61 FR 1209, 3 CFR, 1996 Comp., p. 159).
Disabled Veteran – means (1) 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 (2) A person who was discharged or released from active duty because of a service-connected disability.
Recently Separated Veteran – means a 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.
Voluntary Self-identification - Disability Status
Why are you being asked to complete this form?
Because we do business with the government, we must reach out to, hire, and provide equal opportunity to qualified people with disabilitiesi. 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. Completing this form is voluntary, but we hope that you will choose to fill it out. If you are applying for a job, any answer you give will be kept private and will not be used against you in any way.
If you already work for us, your answer will not be used against you in any way. Because a person may become disabled at any time, we are required to ask all of our employees to update their information every five years. You may voluntarily self-identify as having a disability on this form without fear of any punishment because you did not identify as having a disability earlier.
How do I know if I 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
- Blindness
- Cancer
- Cerebral palsy
- Deafness
- Diabetes
- Epilepsy
- HIV/AIDS
- Impairments requiring the use of a wheelchair
- Intellectual disability (previously called mental retardation)
- Muscular dystrophy
- Bipolar disorder
- Major depression
- Multiple sclerosis (MS)
- Missing limbs or partially missing limbs
- Obsessive compulsive disorder
- Post-traumatic stress disorder (PTSD)
- Schizophrenia
Reasonable Accommodation Notice
Federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. Please tell us if you require a reasonable accommodation to apply for a job or to perform your job. Examples of reasonable accommodation include making a change to the application process or work procedures, providing documents in an alternate format, using a sign language interpreter, or using specialized equipment.
i Section 503 of the Rehabilitation Act of 1973, as amended. For more information about this form or the equal employment obligations of Federal contractors, visit the U.S. Department of Labor's Office of Federal Contract Compliance Programs (OFCCP) website at www.dol.gov/ofccp.
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.
Government Issued Form Name/Number: Form CC-305 | OMB Control Number: 1250-0005 | Expires: 1/31/2020
Auto-Identificación Voluntaria de Discapacidad
¿Por qué se le está pidiendo que complete este formulario?
Debido a que nosotros hacemos negocios con el gobierno, tenemos que acercarnos, contratar y proporcionar igualdad de oportunidades a personas calificadas con discapacidad.I Para ayudarnos a medir que tan bien lo estamos haciendo, le estamos pidiendo que nos diga si usted tiene alguna discapacidad o si alguna vez tuvo alguna discapacidad. Completar este formulario es voluntario, pero esperamos que usted elija hacerlo. Si usted está solicitando un empleo, cualquier respuesta que usted proporcione se mantendrá confidencial y no será utilizada en su contra de ninguna manera.
Si usted ya trabaja para nosotros, su respuesta no será utilizada en su contra de ninguna manera. Debido a que una persona puede convertirse en discapacitada en cualquier momento, estamos obligados a solicitar a todos nuestros empleados que actualicen su información cada cinco años. Usted puede voluntariamente identificar que tiene alguna discapacidad en este formulario sin temor a ningún castigo porque no identificó que tenía alguna discapacidad antes.
¿Cómo puedo saber si tengo una discapacidad?
Se considera que usted tiene una discapacidad si usted tiene un impedimento físico o mental o una condición médica que limita sustancialmente alguna actividad importante de la vida, o si usted tiene un historial o registro de tal impedimento, o condición médica.
Las discapacidades incluyen, pero no se limitan a:
- Ceguera
- Sordera
- Cáncer
- Diabetes
- Epilepsia
- Autismo
- Parálisis cerebral
- VIH/SIDA
- Esquizofrenia
- Distrofia muscular
- Trastorno bipolar
- Depresión aguda
- Esclerosis múltiple (EM)
- Ausencia de extremidades o Ausencia parcial de extremidades
- Trastorno de estrés postraumático (TEPT)
- Trastorno obsesivo-compulsivo
- Deficiencias que requieren el uso de una silla de ruedas
- Discapacidad intelectual (antes llamado retraso mental)
Notificación de Ajustes Razonables
La ley federal requiere que los empleadores proporcionen ajustes razonables a personas calificadas con discapacidades. Favor díganos si usted necesita algún ajuste razonable para solicitar un empleo o para desempeñar su trabajo. Ejemplos de ajustes razonables incluyen hacer un cambio en el proceso de aplicación o los procedimientos de trabajo, proporcionar los documentos en un formato alternativo, el uso de un intérprete de lenguaje de signos, o el uso de equipo especializado.
I I Sección 503 de la Ley de Rehabilitación de 1973, y sus modificatorias. Para obtener más información acerca de este formulario o sobre las obligaciones de igualdad en el empleo de contratistas federales, visite la página web de la Oficina de Programas de Cumplimiento de Contratos Federales (OFCCP, por sus siglas en ingles) del Departamento de Trabajo de los EE.UU. www.dol.gov/ofccp.
DECLARACIÓN PÚBLICA OBLIGATORIA: De acuerdo con la Ley de Reducción de Trámites de 1995 ninguna persona está obligada a responder a una solicitud de información a menos que la misma muestre un número de control OMB válido. Esta encuesta debe tomar alrededor de 5 minutos para ser completada.
Formulario: CC-305 | Numero de Control OMB : 1250-0005 | Vence el: 1/31/2020
Application Authorizations, Certification, and Acknowledgments
By submitting this application I certify that the information contained in this application is correct to the best of my knowledge. I understand that to falsify information is grounds for refusing to hire me, or for discharge should I be hired.
I authorize Marton Technologies or its agents to conduct criminal background checks and contact schools, references, or former employers with respect to the statements and information I provided and my potential for employment. I release Marton Technologies, all agents, schools, and former employers or references from any claim or liability for background checks or for providing reference information. I release Marton Technologies from any claim or liability resulting from utilization of such information.
In consideration for my employment, I agree to abide by the rules and regulations of the company, which rules may be changed, withdrawn, added or interpreted at any time, at the company's sole option and without prior notice to me.
I also acknowledge that my employment may be terminated, or any offer or acceptance of employment withdrawn, at any time, with or without cause, and with or without prior notice at the option of the company or myself.
