Complete the form below to apply for the AmeriCorps Member: Financial Empowerment Center Specialist position: AmeriCorps Member: Financial Empowerment Center Specialist First Name* Middle Initial Last Name* Email* Day Phone Number*Evening Phone Number*Address* City* State*AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificZip Code* Cover Letter File Upload*Accepted file types: doc, pdf, docx, Max. file size: 300 MB.Resume File Upload*Accepted file types: doc, pdf, docx, Max. file size: 300 MB.How did you hear about this position?* Newspaper Classified Ad Company Website Internet Job Board Posting State Employment Office Employee Referral WNYVHC College Career Center Which Newspaper Classified Ad?*Please specify in the box below which newspaper classified ad you found this position in. Which Internet Job Board Posting*Please specify in the box below which internet job board posting (Monster, Indeed, etc...) you found this position on. Invitation to Self IdentifyPLEASE READ ALL INSTRUCTIONS BEFORE COMPLETING THIS FORM Belmont Housing Resources for WNY is an Equal Opportunity Employer committed to the policies and principles of Non-Discrimination and Affirmative Action. To implement these policies and to respond to federal affirmative action recordkeeping and reporting requirements, it is important that the following information be gathered from all applicants and employees. Providing this information is optional. Failure to submit data will not in any way affect your present or future employment. The information provided will remain confidential and be used primarily for government reporting purposes.Your Sex Male Female Your Race/Ethnic Group American Indian or Alaskan Native (Not Hispanic/Latino): Having Origins in any of the original peoples of North America and South America (including Central America) and maintaining tribal affiliation or community attachment. Asian (Not Hispanic/Latino): Having origins in any of the original peoples of the Far East Southeast Asia or the Indian subcontinent including for example Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, The Philippine Islands, Thailand and Vietnam. Black or African American (Not Hispanic/Latino): Having origins in any of the Black racial groups of Africa. Native Hawaiian or other Pacific Islander (Not Hispanic/Latino): Having origins in any of the original peoples of Hawaii, Guam, Samoa or other Pacific Islands. White (Not Hispanic/Latino): Having origins in any of the original peoples of Europe, North Africa or the Middle East. Hispanic/Latino: Having origins in Cuban, Mexican, Puerto Rican, Central or South American or other Spanish culture regardless of race. Two or More Races (Not Hispanic/Latino): Identifies with more than one of the above groups. Veteran StatusClassifications of protected veteran are defined as follows: -A "disabled veteran" is either a veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who would but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs; or a person who was discharged or released from active duty because of a service-connected disability. -A "recently separated veteran" means 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" means 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" means 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. I identify as one or more of the classifications of protected veteran listed above. I am not a protected veteran. Voluntary Self-Identification of DisabilityWhy are you being asked to complete this form? Because we do business with the government, we must reach out to, hire and provide equal opportunities to qualified people with disabilities. To help us measure how well we are doing, we are asking you to tell us if you have a disability or if you ever had a disability. Completing this form is voluntary, but we hope that you will choose to fill it out. If you are applying for a job, and answer you give will be kept private and will not be used against you in any way. If you already work for us, your answer will not be used against you in any way. Because a person may become disabled at any time, we are required to ask all of our employees to update their information every five years. You may voluntarily self-identify as having a disability on this form without fear of any punishment because you did not identify as having a disability earlier. How do I know if I have a disability? You are considered to have a disability if you have a physical or mental impairment or medical condition that substantially limits a major life activity, or if you have a history or record of such an impairment or medical condition. Disabilities include, but are not limited to: -Blindness -Deafness -Cancer -Diabetes -Epilepsy -Autism -Cerebral Palsy -HIV/AIDS -Schizophrenia -Muscular Dystrophy -Bipolar Disorder -Major Depression -Multiple Sclerosis (MS) -Missing Limbs or Partially Missing Limbs -Post Traumatic Stress Disorder (PTSD) -Obsessive Compulsive Disorder -Impairments requiring the use of a wheelchair -Intellectual Disability (previously called Mental Retardation) Yes, I have a disability (or previously had a disability) No, I do not have a disability I do not wish to answer Reasonable Accommodation NoticeFederal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. Please tell us if you require a reasonable accommodation to apply for a job or to perform your job. Examples of reasonable accommodation include making a change to the application process or work procedures, providing documents in an alternate format, using a sign language interpreter or using specialized equipment.