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JRK Enterprises, Inc.

415 Shelton Ave. Alexandria, PA 16611

814-669-1910 Phone

Affirmative Action Voluntary Information

Completion of the information below is voluntary.

We consider all applicants for positions without regard to race, color, religion, sex, national origin, citizenship, age, mental or physical disabilities, veteran/reserve/national guard or any other similarly protected status. We also comply with all applicable laws governing employement practices and do not discriminate on the basis of any unlawful criteria.

To be completed by applicant on a voluntary basis. Not for interview purposes. To be filed separately from application.

In an effort to comply with requirements regarding government record keeping, reporting, and other legal obligaions, which may apply, we invite you to complete this applicant data survey. Providing this information is STRICTLY VOLUNTARY. Failure to provide it will not subject you to any adverse personnel decision or action. Your cooperation is appreciated.

Please be advised that this is NOT a part of your official application for employment. It will not be used in any hiring decision. The information will be used and kept confidential in aaccordwith applicable laws and regulations.

Applicant Information

For Administrative use only

Position(s) applied for       - Available      - Not Available        Hire?           - Yes          -No

Position Hired for______________________                         Date_________________

From the EEO job classication listed below, which one best describes the position filled?

-Officials & Managers                            -Sales Worker                        -Operative (semi-skilled)

-Professionals                                         -Office & clerical Worker      -Laborers (unskilled)

-Technicians -Craft Workers (skilled) -Service Workers

Completed by___________________ Date:__________________________

Position Applied for:


Referral Source






Please Check one of the following Equal Employment Opportunity Identification Groups:

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