CASHCO, INC. APPLICANT DATA SURVEY
Cashco, Inc, is an affirmative action government contractor. In compliance with government regulations, we are required to record the number of applicants by gender and ethnic category.
We ask that you indicate your race or national origin and gender. This information will not be kept with your application and will be used only in accordance with federal and state regulations.
Completion of this form is voluntary and in no way affects the decision regarding your application for employment. This form is confidential and will be maintained separately from your application form.
AFFIRMATIVE ACTION SURVEY
Government agencies require periodic reports on sex, ethnicity, handicapped and veteran status of applicants. This data is for analysis and affirmative action only. Submission of information about a handicap is voluntary.
Cashco is an equal opportunity employer and provides opportunities for all qualified applicants without regard to race, color, religion, national orgin, sex, age or disability.
- Cashco, Inc.
- PO BOX 6
- 607 W 15th
- Ellsworth, KS 67439
BUSINESS / WORK REFERENCES (Do not list relatives.)
ACADEMIC ACHIEVEMENTS AND ACTIVITIES
Please list academic honors, scholarships, or fellowships; memberships in academic honary societies; or participation in or offices held in extracurricular activities you consider significant. (Exclude those indicating race, color, religion, or national origin.)
PROFESSIONAL AND CIVIC MEMBERSHIPS AND ACTIVITIES
(Exclude those indicating race, color, religion, or national origin.)
By submitting this form, I give Cashco the right to contact and obtain information from all references, employers, educational institutions and to otherwise verify the accuracy of the information contained in this application. I hereby release from liability Cashco and its representatives for seeking, gathering and using such information and all other persons, corporations or organizations for furnishing such information.
By submitting this form, I authorize any of the persons, institutions or companies referenced in this application to give Cashco all information concerning my previous employment, education or other information they may have concerning any of the subjects covered by this application.