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City of Orono Supplemental Personnel Data for Affirmative Action Recruitment

  1. Sex:
  2. Age:
  3. Disability status, defined as:
    1) Has a physical or mental condition that substantially or materially limits a major life activity (such as walking, talking, seeing, hearing or learning); 2) Has a history of a disability (such as cancer that is in remission); 3) Is regarded as having such an impairment.
  4. Do you claim disability status?
  5. Leave This Blank:

  6. This field is not part of the form submission.