Employee Self-Identification Forms (00087856). Docx



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#50886

Full Name: ____________________

Department: ___________________



PID: _________________________



Invitation to Voluntarily Self-Identify Veteran Status


The University of North Carolina at Chapel Hill is committed to equal opportunity and affirmative action in all aspects of employment for qualified protected veterans. We ask that you please consider completing this Invitation to Voluntarily Self-Identify Veteran Status to help us fulfill our commitments to equal opportunity and affirmative action and to meet our obligations as a government contractor under the Vietnam Era Veterans’ Readjustment Assistance Act of 1974, as amended by the Jobs for Veterans Act of 2002, 38 U.S.C. 4212 (VEVRAA). VEVRAA requires us to take affirmative action to employ and advance in employment protected veterans.
While the University is required by VEVRAA to submit an annual report to the U.S. Department of Labor identifying the total number of employees who are “protected veterans” based on the categories listed below, submission of this information is voluntary on your part and refusal to provide it will not subject you to any adverse treatment. The information provided will be used only in a manner consistent with VEVRAA.
Protected Veteran classifications are defined as follows:


  • A "disabled veteran" is one of the following:




    • 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




    • 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, (Period of War Dates: Korean Conflict June 27, 1950 – January 31,1955; Vietnam Era February 28, 1961 – May 7, 1975 for veterans serving in the Republic of Vietnam or August 5, 1964 – May 7, 1975 for all other cases; Persian Gulf War August 2, 1990 – current).




  • 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.



Self-Identification:
Are you a protected veteran:
☐I am a protected veteran ☐I am NOT a protected veteran ☐I choose not to ID

Reasonable Accommodation Notice: If you are a disabled veteran and require a reasonable accommodation that would enable you to perform the essential functions of the job, including special equipment, changes in the physical layout of the job, changes in the way the job is customarily performed, provision of personal assistance services or other accommodations, please contact the Equal Opportunity and Compliance Office at 919-966-3576

or eoc@unc.edu.
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