Applicant Self Identification Form

As a Federal Contractor, V2Soft, inc. is required to solicit and collect data on race, ethnicity, and
gender on all applicants. Voluntary self-reporting or self-identification is the preferred method for
collecting data on race, ethnicity, and gender. Therefore we invite you to complete this self
identification form, attach it to your resume/application and submit both to the appropriate contact
listed on the job posting for which you are applying.
By completing this form, you are verifying that the information you are providing is accurate and that
you understand that this information will be kept strictly confidential; that disclosure of this information
does not in any way effect whether or not your application receives consideration; and that the sole
use of this information is for inclusion in statistical reports required by various governmental
regulations and agencies.

Date of Application:
Position of Interest:
Location (City, State/Facility):
Last Name:
First Name:
Middle Name:
Select one of the following:
Female:

Male:

Select ONE of the following:

Hispanic or Latino

White

Black or African American

Native Hawaiian or other Pacific Islander

Asian

American Indian or Alaska Native

Two or More Races (Not Hispanic or Latino)

Racial Category Definitions

American Indian or Alaskan Native - A person having origins in any of the original peoples of
North America and South America (including Central America), and who maintains tribal
affiliations or community attachment.
Asian - 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 Island, Thailand, and Vietnam.
Black or African American - A person having origins in any of the Black racial groups of Africa.
Terms such as Haitian or Negro can be used in addition to Black or African American.
Native Hawaiian or Other Pacific Islander - A person having origins in any of the original
peoples of Hawaii, Guam, Samoa, or other Pacific Islands.
White - A person having origins in any of the original peoples of Europe, North Africa, or the
Middle East.
Hispanic or Latino (All races) - A person of Mexican, Puerto Rican, Cuban, Central or South
American, or other Spanish culture or origin, regardless of race.
Hispanic or Latino (White race only) - A person of Mexican, Puerto Rican, Cuban, Central or
South American or other Spanish culture or origin, and of the White race.
Hispanic or Latino (all other races) - A person of Mexican, Puerto Rican, Cuban, Central or
other Spanish culture or origin, and of any race other than white.