BOWIE STATE UNIVERSITY
Affirmative Action Program
CONFIDENTIAL VOLUNTARY APPLICANT DATA FORM
TO THE APPLICANT: This employer is a Government contractor subject to 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), which requires Government contractors
to take affirmative action to employ and advance in employment: (1) disabled veterans; (2) recently separated veterans; (3) active
duty wartime or campaign badge veterans; and (4) Armed Forces service medal veterans. These 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.
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.
Protected veterans may have additional rights under USERRA—the Uniformed Services Employment and Reemployment Rights Act.
In particular, if you were absent from employment in order to perform service in the uniformed service, you may be entitled to be
reemployed by your employer in the position you would have obtained with reasonable certainty if not for the absence due to service.
For more information, call the U.S. Department of Labor’s Veterans Employment and Training Service (VETS), toll-free, at 1-866-4-
If you believe you belong to any of the categories of protected veterans listed above, please indicate by checking the appropriate box
below. As a Government contractor subject to VEVRAA, we request this information in order to measure the effectiveness of the
outreach and positive recruitment efforts we undertake pursuant to VEVRAA.
I IDENTIFY AS ONE OR MORE OF THE CLASSIFICATIONS OF PROTECTED VETERAN LISTED ABOVE
I AM NOT A PROTECTED VETERAN
RACE/ETHNIC IDENTIFICATION – PLEASE CHECK ALL THAT APPLY
Hispanic or Latino (A person of Cuban, Mexican, Puerto
Rican, South or Central American, or other Spanish culture or
origin, regardless of race.)
Native Hawaiian or other Pacific Islander (A person having
origins in the original peoples of Hawaii, Guam, Samoa,
or other Pacific Islands.)
American Indian or Alaska Native (A person having origins in
any of the original peoples of North or South America,
including Central America, and who maintains tribal affiliations or
Black or African American (A person having origins in any of the
black racial groups of Africa.)
Asian (A person having origin 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.)
White/Caucasian (A person having origins in any of the original
peoples of Europe, the Middle East, or North Africa.)
How did you hear about this vacancy:
Newspapers/Chronicle of Higher Education
Other State Agency (please specify):
Website (please specify):
BSU Office of Human Resources
Maryland Workforce Exchange
EEO-1 Job Category (to be completed by the EEO/AA Officer): ______________