Copy of Employment Equity Self-Identification Questionnaire - Anonymous and Confidential

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* 1. Introductory Statement

In support of NOSM University's commitment to employment equity, the University is conducting a survey to gather data about representation among historically under-represented groups. Completion is voluntary but participation is encouraged as this data will be used to respond to improve our recruitment efforts. All data collected is anonymous (no I.P Addresses will be collected) and will be treated confidentially through Human Resources.

Thank you for taking the time to help us improve our processes.

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* 2. I do not wish to complete the survey.

Check here if you do not wish to complete the survey.

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* 3. Women are a designated group because they have faced, and continue to face, barriers to employment.
Do you self-identify as a woman?

Yes

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* 4. For the purposes of employment equity, “persons of a minority sexual orientation” means persons who are gay, lesbian, bi-sexual, two-spirited, queer, trans* etc. Based on this definition, do you consider yourself to be a person of a minority sexual orientation?

Yes

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* 5. Based on the Federal Contractors Program definitions, a person is an Indigenous/Aboriginal person if they are a member of the Indian (status or non status), Inuit or Metis people of North America. Based on this definition, do you consider yourself to be an Indigenous person?

Yes

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* 6. Do you self identify as Francophone?

Yes

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* 7. Do you self identify as Rural / Remote (live in a population of less than 10,000, born in a rural or remote or living in a rural and remote community or teaching or practicing in a rural or remote community).

Yes

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* 8. For the purposes of employment equity, members of racialized groups/visible minorities means persons, other than Aboriginal / Indigenous people, who are non-Caucasian in race or non-white in colour. Please note that this question does not refer to the country in which you were born, your citizenship or your religion.

Do you self-identify as a member of a racialized group/visible minority?

Yes

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* 9. If you answered yes to the question above, please identify which group to which you most identify with:

Black (e.g., African Black, American Black, Canadian Black, West Indian Black)

South Asian (e.g., Indian, Pakistani, Sri Lankan, Bangladeshi, Polynesian

Southeast Asian (e.g., Burmese, Cambodian, Filipino, Malaysian, Laotian, Thai, Vietnamese)

West Asian/ Arab (e.g., Syrian, Egyptian, Turkish, Iranian, Israeli, Lebanese, Palestinian)

Mixed race

Other

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* 10. Persons with disabilities are persons who have a long-term or recurring physical, mental, sensory, psychiatric or learning impairment. This definition includes persons whose functional limitations owing to their impairment have been accommodated in their current job or workplace.

Do you self-identify as a person with a disability?

Yes

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* 11. If you answered yes to the question above, please select as many as apply to you from the list below.

Coordination/dexterity impairment

Development impairment (e.g., Down's Syndrome)

Hearing impairment - hard of hearing

Hearing impairment – deaf

Learning disability or comprehension impairment (e.g., dyslexia)

Mobility impairment (e.g., need to use a wheelchair)

Non-visible physical impairment (e.g., epilepsy, diabetes

Psychiatric disability (e.g., severe depression)

Visual impairment - partially sighted (excluding use of prescription eyewear)

Visual impairment - blind

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* 12. All data contained is this survey is anonymous data that will be used to collate information for Accreditation reporting and will be used to comply with the Federal Contractors Program, which includes development of employment equity programs .The questions are in compliance with Schedule IV of the Employment Equity Regulations per the Employment Equity Act (federal statute).
Please take a moment to indicate if you belong to the following employment group.

Non - Union Staff

Unit 1 -Faculty

Unit 1 Professional Staff / Librarians

Unit 2- Staff

Management

Senior Management

Copy of Employment Equity Self-Identification Questionnaire - Anonymous and Confidential

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* 2. I do not wish to complete the survey.

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* 3. Women are a designated group because they have faced, and continue to face, barriers to employment. Do you self-identify as a woman?

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* 4. For the purposes of employment equity, “persons of a minority sexual orientation” means persons who are gay, lesbian, bi-sexual, two-spirited, queer, trans* etc. Based on this definition, do you consider yourself to be a person of a minority sexual orientation?

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* 5. Based on the Federal Contractors Program definitions, a person is an Indigenous/Aboriginal person if they are a member of the Indian (status or non status), Inuit or Metis people of North America. Based on this definition, do you consider yourself to be an Indigenous person?

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* 6. Do you self identify as Francophone?

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* 7. Do you self identify as Rural / Remote (live in a population of less than 10,000, born in a rural or remote or living in a rural and remote community or teaching or practicing in a rural or remote community).

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* 9. If you answered yes to the question above, please identify which group to which you most identify with:

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* 11. If you answered yes to the question above, please select as many as apply to you from the list below.

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* 3. Women are a designated group because they have faced, and continue to face, barriers to employment.
Do you self-identify as a woman?