
STATE OF GEORGIA
STANDARD APPLICATION FOR EMPLOYMENT
An Equal Opportunity Employer
(DOAS 27-1) Rev. 02-2015 4
EQUAL EMPLOYMENT OPPORTUNITY
SELF IDENTIFICATION FORM
The State of Georgia provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to
race, color, religion, sex, national origin, age, disability, or genetics. In addition to federal law requirements, the State of Georgia complies
with applicable state and laws governing nondiscrimination in employment in every location in which the State of Georgia has facilities. This
applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer
leaves of absence, compensation, and training.
The information you provide in this section is optional. The information will be used by state agencies to comply with Federal
guidelines for monitoring the equal employment opportunity efforts of the State of Georgia and for no other reason. Your answers will be
will not be used against you in any way.
Race/Ethnicity
☐ American Indian or Alaska Native
☐ Asian
☐ Black or African American
☐ Hispanic or Latino
☐ Native Hawaiian or Other Pacific Islander
☐ Two or More Races
☐ White
☐ I do not wish to provide this information
Gender
☐ Female
☐ Male
☐ I do not wish to provide this information
Veteran
The laws of the State of Georgia afford some degree of preference to veterans in certain initial employment decisions. If
you believe you belong to any of the categories of veterans listed below and have not been dishonorably discharged,
please indicate by checking the appropriate box below. DD214 and/or other supporting documents will be required.
☐ US Armed Forces Veteran ☐ Disabled Veteran (at least 10% disability)
☐ Disabled Veteran’s Spouse ☐ Deceased Veteran’s Widow/Widower
For Agency Use: