Voluntary Self-Identification Form

Hudson County Community College does not discriminate on the basis of race, color, gender, religion, age, marital status, pregnancy, sexual orientation, national or ethnic origin, disability, genetic information, gender identity or expression, or veteran status in any program or activity administered by the College.

The information you provide will remain confidential. The completed survey contains no reference to your name and it will be maintained separately from your applicant file in the compliance office or other designated location. Applicant Data Forms, without names, will be retained in the compliance office or other designated location for the purpose of compiling information about the applicant pool, and to assist the College in the evaluation/enhancement of its affirmative action recruitment efforts.

Question Title

* 1. What is your gender?

Question Title

* 2. Are you of Hispanic or Latino origin or descent?

Question Title

* 3. Which race/ethnicity best describes you? (Please choose only one.)

Question Title

* 4. Are you a person living with a disability?

Disability means any person who:
  • has a physical or mental impairment which substantially limits one or more major life activities;
  • has a record of such impairment; or
  • is regarded as having such an impairment

Question Title

* 5. Veteran Status
(Please check all that apply)

Question Title

* 6. What prompted you to apply to Hudson County Community College.

Question Title

* 7. Please provide the title of the position you are applying for:

T