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Office: SLC 2031 Phone: 4025597276 Fax: 4025599671 Email: unmcasc@unmc.eduMEDICAL EVALUATION First Name: ___Last Name: ___NU ID: ___Date of Birth: ___College/Program: I have reviewed the medical status
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Obtain a copy of the self-identification form from the relevant organization or department.
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Read the instructions carefully before filling out the form.
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Fill out your personal information accurately, including your name, address, contact details, and any other required details.
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Provide information about your background, such as your ethnicity, gender, and any disabilities or veteran status.
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Review the form to ensure all sections are completed accurately and legibly.
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Sign and date the form, if required, and submit it to the appropriate party within the given deadline.

Who needs self-identification form?

01
Individuals who are required to self-identify for purposes of diversity and inclusion initiatives.
02
Organizations that are collecting data on employee demographics for reporting purposes.
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It is a form used for individuals to voluntarily disclose information about themselves, such as race, gender, disability status, etc.
It is usually required by employers to be completed by their employees.
The form typically requires individuals to select relevant categories and provide other requested information.
The purpose is to gather demographic data for reporting and compliance purposes, as well as to promote diversity and inclusion.
Typically includes categories like race, gender, veteran status, disability status, etc.
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