EEO Self Identification Jobs with United Hospital Services Feel free to contact us by filling out the form below. EEO Self Identification Form It is the policy of this organization to provide equal employment opportunity to all qualified applicants for employment without regard to race, color, religion, national origin, gender, age, veteran status or disability. This organization is subject to certain nondiscrimination and affirmative action record-keeping and reporting requirements which require us to invite job applicants and employees to voluntarily self-identify their race/ethnicity and gender. The information obtained will be kept confidential and may only be used in accordance with the provisions of applicable federal laws, executive orders, and regulation, including those which require the information to be summarized and reported to the federal government for civil rights enforcement purposes. COMPLETION OF THIS FORM IS VOLUNTARY AND IN NO WAY AFFECTS THE DECISION REGARDING YOUR APPLICATION FOR EMPLOYMENT. THIS FORM IS CONFIDENTIAL AND WILL BE MAINTAINED SEPARATELY FROM YOUR APPLICATION FORMS. Name: * Last Name: First Name * First Name: Middle Name Middle Name: Position Applied for: * Delivery Driver - English Laundry Worker - (In Espanõl) Laundry Worker - English What is your gender Male Female What is your race/ethnicity? * Hispanic/Latino: a person of Cuban, Mexican, Chicano, Puerto Rican, South or Central American, or 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. 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. Native Hawaiian or Pacific Islander (not Hispanic or Latino): 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. Date Submit If you are human, leave this field blank. Our mission is to launder excellent quality linen for Indianapolis area hospitals while maintaining the highest standards in cost control, value engineering, delivery and customer satisfaction.