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Westmoreland County, An Equal Opportunity Employer, Applicant Information - Confidential

  1. This information is collected from all applicants for purposes of complying with equal Employment Opportunity and Affirmative Action laws and regulations. It will not be used as selection criteria and will be treated as personal and confidential. Completion of this form is VOLUNTARY.

  2. Sex

  3. Ethnic Category

  4. DISABILITY AND VETERAN CATEGORY

  5. A qualified disabled individual is a person who (1) has a physical or mental impairment which substantially limits one or more of that person's major life activities, or (2) has a record of such impairment, or (3) is regarded as having such impairment, and (4) is capable (qualified) of performing a particular job with reasonable accommodation to his/her disability.

  6. A qualified disabled veteran is (1) a person entitled to disability compensation under laws administered by the Veteran's Administration for disability at 30% or more, or (2) a person whose discharge or release from active duty was for a disability incurred or aggravated in the line of duty, and (3) is capable (qualified) of performing a particular job with reasonable accommodation to his/her disability.

  7. A Vietnam Era veteran is (1) a person who a) actively served for more than 180 days, any part of which occurred between August 5, 1964 and May 7, 1975 and was released with other than a dishonorable discharge, or b) was released from such active duty for a service-connected disability, and (2) a person who was discharged/released within 48 months prior to an alleged violation of the Act and/or of the regulation issued thereunder on July 26, 1976.

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