Self-Identification Form

NewBridge is an equal opportunity employer and does not discriminate on the basis of race, color, religion, gender, age, national origin, disability, veteran status, sexual orientation or any other basis protected by applicable law. The information provided below will be used in the compilation of data for government reporting. Completion of this data is voluntary and will not affect your opportunity for employment or, if hired, the terms or conditions of employment.

Position applying for

Date of Birth

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American Indian/Native American or Alaskan Native (not Hispanic or Latino) – A person having origins in any of the original peoples of North and South America (including Central America), and who maintain tribal affiliation or community attachment.

Asian – Persons having origins in any of the original peoples of the Far East, Southeast Asia or the Indian Subcontinent, including Cambodia, China, Japan, Korea, India, Malaysia, Pakistan, Nepal, the Philippine Islands, Thailand and Vietnam.

Native Hawaiian or Other Pacific Islander – Persons having origins in any of the original peoples of Hawaii, Guam, Samoa or other Pacific Islands.

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/African American (not Hispanic or Latino) – A person having origins in any of the black racial groups of Africa.

Two or more races – All persons who identify with more than one of the above races.

I do not wish to self-identify.

How did you hear about the position?