This station is required by the Federal Communications Commission to collect the following information in order to comply with their regulations and other Federal laws relating to equal employment opportunity. This information would be used only for the report submitted to the FCD or other Federal agencies as required by law. You do not have to provide this information; however, if you do provide this information, we can assure you that it will not be used in processing your employment application or in any employment decisions.
Please check one:
[ ] White (not Hispanic)
[ ] Black (not Hispanic)
[ ] Hispanic
[ ] Asian/Pacific Islander
[ ] American Indian/Alaska Native
Please identify the specific referral source through which you learned about this position (name of newspaper, magazine, school placement office, employment agency, station employee, on-air station ad, or other source):
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