City Program Manager Coordinator (Tailored Programming) Name * First Name Last Name What are your pronouns? * Email * Phone * (###) ### #### Current location Current Company/University LinkedIn http:// Do you understand this is an unpaid internship/volunteer position? * Yes No U.S. EQUAL EMPLOYMENT OPPORTUNITY INFORMATION (Completion is voluntary and will not subject you to adverse treatment) * InventHER provides equal employment and affirmative action opportunities to applicants and employees without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, or disability. We invite all applicants to voluntarily self-identify their race, ethnicity, and gender. Submission of the information on this form is strictly voluntary and refusal to provide it will not subject you to any adverse treatment. Information obtained will be retained in a confidential file and separate from personnel records. This information may only be used in accordance with the provision of applicable federal laws, executive orders, and regulations. If you want more information about any of the sections, please check with a company representative. Yes No Gender Male Female Nonbinary Decline to self-indentify What is your race/ethnicity? Please select all that apply * American Indian or Alaska Native Asian Black or African American Hispanic or Latinx Native Hawaiian/ Other Pacific Islander White Other Prefer not to answer SELF-IDENTIFICATION OF VETERAN STATUS (Completion is voluntary and will not subject you to adverse treatment) I am a vetran I am not a veteran I decline to self-identify VOLUNTARY SELF-IDENTIFICATION OF DISABILITY Yes, I have a disability or have had one in the past No, I do not have a disability or have had one in the past I do not want to answer Thank you for applying to the role of City Program Manager Coordintator (Tailored Programming) We’ll be in touch soon with next steps!