SI Form

Pre-Offer Self-Identification Form


    We are required to comply with the Vietnam Era Veterans’ Readjustment Act of 1974 (“VEVRAA”), as amended, which requires government contractors to take affirmative action to employ and advance in employment: (1) disabled veterans; (2) recently separated veterans; (3) active duty wartime or campaign badge veterans; and (4) Armed Forces service medal veterans covered by VEVRAA as defined below.
    • A Disabled Veteran - (1) A veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs, or (2) A person who was discharged or released from active duty because of a service-connected disability.
    • A Recently Separated Veteran – any veteran during the three-year period beginning on the date of such veteran’s discharge or release from active duty in the U.S. military, ground, naval or air service.
    • An Active-Duty Wartime or Campaign Badge Veteran – a veteran who served on active duty in the U.S. military, ground, naval or air service during a war or in a campaign or expedition for which a campaign badge has been authorized under the laws administered by the Department of Defense.
    • An Armed Forces Service Medal Veteran – a veteran who, while serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985.
    If you are a veteran covered by VEVRAA, we would like to invite you to participate in our affirmative action program. You may inform us of your desire to benefit under this program at this time and/or at any time in the future. The Company’s affirmative action program describes the Company’s commitment to undertaking affirmative action to recruit, place and advance in employment covered veterans. Submission of this information is voluntary and refusal to provide it will not subject you to any adverse treatment. Protected veterans may have additional rights under USERRA - the Uniformed Services Employment and Reemployment Rights Act. In particular, if you were absent from employment in order to perform service in the uniformed service, you may be entitled to be reemployed by your employer in the position you would have obtained with reasonable certainty if not for the absence due to service. For more information, call the U.S. Department of Labor’s Veterans Employment and Training Service (VETS), toll-free, at 1-866-4-USA-DOL. If you believe you belong to any of the categories of protected veterans listed above, please indicate by checking the appropriate box below. As a government contractor subject to VEVRAA, we request this information in order to measure the effectiveness of the outreach and positive recruitment efforts we undertake pursuant to VEVRAA.

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