Thank you for filling out this form to help Solid Ground's Human Resources (HR) Department track applicant data.All requested information is voluntary. You're not required to provide it for your application to be complete – and HR will remove it from your application packet before distributing for screening and selection. PLEASE NOTE: A confirmation screen will pop up when you've successfully submitted your data supplement. If you click the SUBMIT button and don't see the confirmation message, click SUBMIT again.Today's Date MM slash DD slash YYYY Position Title Please fill in the position title you are applying for as shown on the job announcement.Personal InformationName Email Sex Female Male Nonbinary Position You're Applying For Sex Female Male Ethnic/Racial BackgroundIf you're a person with a multi-racial or multi-cultural background, please check all appropriate boxes. Black or African American Asian Native Hawaiian or Pacific Islander Hispanic or Latino Caucasian American Indian or Alaska Native Two or More Races Other Please enter ethnic/racial background Are you living with a disability? Yes No Do you have the ability, with or without reasonable accommodation, to perform the essential function of the position for which you are applying? Yes No If "no," please explain:Are you a veteran? Yes No How did you learn about this employment opportunity? Friend or Relative Solid Ground Employee Solid Ground Website Job Fair Online Job Board Social Media Other Friend or relative name Solid Ground employee name Name and/or date of job fair Which social media? Facebook Linkedin Which job board? Craigslist DiversityJobs Idealist LinkedIn Indeed College/University Job Board UW School of Social Work Distribution list Please specify Do you have relative(s) and or friend(s) employed by Solid Ground?If yes, please specify:Name Relationship Job Title Location Certification of Data SupplementBy checking YES below, I certify that the answers given herein are true and complete to the best of my knowledge. YES Name and Date of Certification Δ