CANADIAN UNION OF LABOUR EMPLOYEES

SELF-IDENTIFICATION QUESTIONNAIRE

(Voluntary Participation)

The objective of this Self ID formis to achieve equality and representation in your Union for:First Nationspeoples (Aboriginal, Inuit and Métis), persons with disabilities, racially visible persons, and lesbians, gays, bi-sexuals and transgenders.

All of the individual information collected from this questionnaire will be kept confidentialamong the CULE Executive. This questionnaire will assist us in the selection processes for the Equity Caucus and the Equity Director.

IDENTIFYING YOURSELF

The following may be used to further clarify which group you may identify with.

ABORIGINAL PEOPLES OF CANADA

An Aboriginal person identifies as being a First Nations, Inuit or Métis. Members of a First Nations include: status, treaty or registered, as well as non-status and non-registered.

Based on the above description, you may identify as:

First Nations member

Inuit

Métis

RACIALLY VISIBLE PERSONS

A racially visible person is anyone, other than Aboriginal peoples, who are non-white in colour or non-Caucasian in race, regardless of place of birth.

Based on the above description, you may identify as:

Chinese

Filipino

Japanese

Korean

Black, African-Canadian, Person of African-Descent

SouthAsian, Persons of Indian Descent (including East Indians from India; Bangladesh; Pakistan;East Africa) and West Indians from Guyana, Trinidad & Tobago,; etc.)

Southeast Asian (including Burmese; Cambodian; Laotian, Thai; Vietnamese; etc.)

Non-White West Asian, North African or Arab (including Egyptian; Libyan; Lebanese; Iranian; etc.)

Non-White Latin American (including indigenous persons from Central America and South America, etc.)

PERSONS WITH DISABILITIES

For the purposes of our survey, a person with a disability is someone who has a persistent physical, mental, psychiatric, sensory or learning impairment, and,

The person considers himself or herself to be disadvantaged in employment by reason of that impairment, or

The person believes that an employer or potential employer is likely to consider the person to be disadvantaged in employment by reason of that impairment.

This definition includes persons whose functional limitations, due to their impairment, have been accommodated in their current job or workplace.

Based on the above description, you may identify as:

Co-ordination or dexterity(difficulty using hands or arms, for example, for grasping or handling a stapler or using a keyboard)

Mobility(difficulty moving around, for example, from one office to another or up and down stairs)

Epilepsy

Blind or visual impairment (unable to see or difficulty seeing)

Deaf or hard of hearing (unable to hear or difficulty hearing)

Speech impairment (unable to speak or difficulty speaking)

SEXUAL ORIENTATION

For the purposes of our survey, you may identify as:

Lesbian

Gay

Bi-sexual

Transgender/Transsexual

COMMENTS

If you have any inquiries or comments, including changes in terminology,

please contact your CULE Director.

Please return this form to:

JoanAnne Gravesande

CULE Equity Director

c/o Toronto Regional Office

SELF IDENTIFICATION (OPTIONAL)

The Canadian Union of Labour Employees is committed to ensuring representation and accessibility to all members. The information requested in this section will assist in reaching members who belong to equity groupsas identified in the CULE Constitution.

All information will be kept confidential

Please indicate with a checkmark  if you belong to any of the following groups / YES / NO
Aboriginal,
Inuit
Métis
Racially Visible
Member with disabilities
Gay
Lesbian
Transgender
Bisexual
Additional Information/comments