Applicant Data Survey

Share & Bookmark, Press Enter to show all options, press Tab go to next option
Print
Please correct the fields below:

Applicants are considered for all positions, and employees are treated during employment without regard to race, color, religion, sex, national origin, age, marital or veteran status, medical condition or disability.

As employers, we comply with government regulations and affirmative action responsibilities.

Solely to help us comply with government record keeping, reporting and other legal requirements, please fill out the Applicant Data Survey. We appreciate your cooperation.

This data is for periodic government reporting and will be kept in a Confidential File separate from the Application for Employment.

Name
Name
Date
Position(s) applied for
Position(s) applied for
Referral Source: (Check all that apply)
Referral Source: (Check all that apply)
Do you live within the Yankton city limits?
Do you live within the Yankton city limits?
Within 10 miles of the city limits?
Within 10 miles of the city limits?
Were you treated courteously when requesting information about employment with the City?
Were you treated courteously when requesting information about employment with the City?
Was City employment information readily available?
Was City employment information readily available?
Was City employment information easily understood?
Was City employment information easily understood?

AFFIRMATIVE ACTION SURVEY

Government agencies require periodic reports on the sex, ethnicity, disability and veteran status of applicants. This data is for analysis and affirmative action only. Submission of information about a disability is voluntary.

Please check all that apply:
Sex
Sex
Race
Race
Other Status
Other Status
Age
Age
  1. To receive a copy of your submission, please fill out your email address below and submit.