INVITATIONTO SELFIDENTIFY RACE,GENDERANDAS A PROTECTED VETERAN
ToenableustomeetgovernmentreportingregulationsandmaintainanAffirma-tiveActionPlan,CGI,Inc.requeststhatyoucompletethispersonaldataform.Informationwillbeusedsolelyforgovernmentreportingpurposesandwillbedetachedandkeptseparatefromyourfile.AnyinformationthatyouchoosetoprovidewillnotbeconsideredbyCGI,Inc.foremploymentpurposesandwillbetreatedaspersonalandconfidential.Yourvoluntarycooperation is appreciated.
Name: LastFirstMiddleInitial
GENDER
□Female
□Male
RACE/ETHNICITY
Please check theappropriate box(es) below.
Date:
□HispanicorLatino-ApersonofCuban,Mexican,PuertoRican,Southor
CentralAmerican, orother Spanishculture ororigin, regardlessof race.
□White(NotHispanicorLatino)–Apersonhavingoriginsinanyoftheoriginalpeoples of Europe, theMiddle East, or NorthAfrica.
□Black or African-American(Not HispanicorLatino)-Aperson having originsin anyofthe blackracialgroupsof Africa.
□NativeHawaiianorOtherPacificIslander(NotHispanicorLatino)-ApersonhavingoriginsinanyoftheoriginalpeoplesofHawaii,Guam,Samoa,orother PacificIslands.
□Asian(NotHispanicorLatino)-ApersonhavingoriginsinanyoftheoriginalpeoplesoftheFarEast,SoutheastAsia,ortheIndianSubcontinent,including,forexample,Cambodia,China,India,Japan,Korea,Malaysia,Pakistan, thePhilippine Islands,Thailand,andVietnam.
□AmericanIndian orAlaska Native(NotHispanicor Latino)-Aperson havingoriginsinanyoftheoriginalpeoplesofNorthandSouthAmerica(includingCentralAmerica),andwho maintaintribalaffiliation orcommunityattachment.
CGI, Inc. is a federal contractor subject to the Vietnam Era Veterans’ReadjustmentAssistanceActof1974,asamendedbytheJobsforVeteransActof2002,38
U.S.C.4212(“VEVRAA”),whichrequirescontractorstotakeaffirmativeactiontoemployandadvance in employment:
(1)disabledveteransdefinedas(a)veteransoftheU.S.military,ground,navalorairservice whoare entitledtocompensation(orwhobut for the receiptof militaryretiredpaywouldbeentitledtocompensation)underlawsadministeredbytheSecretaryofVeteransAffairs;or(b)personswhoweredischargedorreleasedfromactivedutybecause ofa service-connecteddisability;
(2)recentlyseparatedveteransdefinedasanyveteransduringthethree-yearperiodbeginningonthedateofsuchveteran’sdischargeorreleasefromactivedutyinthe
U.S.military,ground, naval, or air service;
(3)activedutywartimeorcampaignbadgeveteransdefinedasveteranswhoservedonactivedutyintheU.S.military,ground,navalorairserviceduringawar,orinacampaignorexpeditionforwhichacampaignbadgehasbeenauthorizedunderthelawsadministeredbytheDepartment ofDefense;and
(4)ArmedForcesservicemedalveteransdefinedasveteranswho,whileservingonactivedutyintheU.S.military,ground,navalorairservice,participatedinaUnitedStatesmilitaryoperationforwhichanArmedForcesservicemedalwasawardedpursuant to Executive Order 12985.
Ifyoubelieveyoubelongtoanyofthecategoriesofprotectedveteranslistedabove,pleaseindicatebycheckingtheappropriateboxbelow.AsagovernmentcontractorsubjecttoVEVRAA,werequestthisinformationinordertomeasuretheeffectivenessoftheoutreachandpositiverecruitmenteffortsweundertakepursuanttoVEVRAA.Thisinformationisbeingrequestedonavoluntarybasisandwillbekeptconfidential,consistentwithapplicablelaw.Refusaltoprovidetherequestedinformationwillnotsubjectyoutoanyadversetreatment.Ifprovided, this informationwill not be used in a manner inconsistentwithVEVRAA.
□I IDENTIFY AS ONE OR MORE OF THE CLASSIFICATIONS OFPROTECTED VETERANLISTED ABOVE.
□I AMNOT A PROTECTED VETERAN.
□ICHOOSE NOT TO SELFIDENTIFY.