SOTC Applicant Data Record
SUBMISSION OF THIS INFORMATION IS VOLUNTARY ONLY
To assist us in complying with federal guidelines, periodic reporting, and other legal requirements, please supply the information requested below. This information will be kept confidential and separate from the application.

Position For Which You Are Applying:
Referral Source:
Advertisement
Friend
Relative
Employment Agency
Internet
First Name:
Middle Initial:
Last Name:
Phone:
Address Number:
Address Street:
City:
State:
Zip:
GenderMaleFemale
Employee Race/Ethnic Group:
Asian
African American (Black)
American Indian/Alaska Native:

Tribe:

Enrolled (Card Carrying):

Yes No
Hispanic/Latino
Native Hawaiian or Other Pacific Islander
Caucasian (White)
Two or More Races not Hispanic/Latino
Other/Unknown

Please specify:

Are you a veteran?NoYes

Southern Oklahoma Technology Center is an Equal Opportunity Employer and does not discriminate with regard to race, color, religion, gender, national origin, age, marital or veteran status, or disability.