Holiday Wholesale | Voluntary Self Identification Form

Holiday Wholesale, Vacationland Vendors, Travel Mart, and Dunkin’ Donuts are Equal Opportunity
Employers. Applicants for employment are invited to participate in the program by reporting their status as
handicapped, disabled veteran, veteran of the Vietnam era or other minority. In extending this invitation you are
also advised that: (a) workers (applicants) are under no obligation to respond, but may do so in the future if they
choose; (b) responses will remain confidential within the Human Resources Department; and (c) responses will
be used only for the necessary information to include in our program. We are a company that values diversity.
We actively encourage women and minorities to apply. Refusal to provide this information will have no bearing on
your application and will not subject you to any adverse treatment. Please complete the information requested
below. Thank you for your cooperation.

General Applicant Information

Name

Date

Position Applied For

Please Check All That Apply

Race or Ethnic Identity

Hispanic or Latino
White (not Hispanic or Latino)
Black or African American (not Hispanic or Latino)
Native Hawaiian or Pacific Islander (not Hispanic or Latino)
Asian (not Hispanic or Latino)
American Indian or Alaskan Native (not Hispanic or Latino)
Two or More Races (not Hispanic or Latino)

Veteran Status

Vietnam Era Veteran
Special Disabled Veteran
Other Protected Veteran
Recently Separated Veteran
Armed Forces Services Medal

Gender

Male
Female
Prefer Not to Answer

Other

Individual with Disabilities
I do not wish to Self-Identify

Digital Signature

How did you hear about our opening?

Current Employee
Newspaper Ad
Recruiter
Other

If "OTHER", please explain

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Name

This field is for validation purposes and should be left unchanged.