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City of Fremont - 400 E Military Ave - Fremont, NE 68025-5141
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Equal Empployment Opportunity (EEO)

  1. Fremont, NE logo

  2. Voluntary Self-Identification Form

    Qualified applicants are considered for employment without regard to race, religion, sex, national origin, age, marital status, sexual orientation, veteran status, disability, or other protected characteristic.

    The employer is subject to certain governmental recordkeeping and reporting requirements for the administration of civil rights laws and regulations. In order to comply with these laws, the employer invites employees to voluntarily self-identify their race or ethnicity. Submission of this information is voluntary and refusal to provide it will not subject you to any adverse treatment. The information obtained will be kept confidential and may only be used in accordance with the provisions of applicable laws, executive orders, and regulations, including those that require the information to be summarized and reported to the federal government for civil rights enforcement. When reported, data will not identify any specific individual.

  3. This detatachable and separate form will be kept in a confidential file separate from your application for employment.

  4. Gender Identification

    (Check one)

  5. Race / Ethnic Identification

    (check one)

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  7. This field is not part of the form submission.