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Providing the information requested below is voluntary and will assist in maintaining affirmative action programs to promote employment opportunities of disabled individuals, special disabled veterans, and other protected veterans. Such disclosure by you will further enable the company to assist you in an appropriate manner concerning your employment. Disclosure or refusal to provide such information will in no way result in adverse treatment. All information regarding your disability will be kept confidential and will be sued only in ways consistent with federal reporting requirements, except that (1) supervisors and managers may be informed regarding restrictions on the work duties of individuals with disabilities and disabled-veteran employees, and regarding necessary accommodations; (2) first-0aid and safety personnel may be informed, when and to the extent appropriate, if a conditions might require emergency treatment; and (3) government officials engaged in enforcing the Americans with Disabilities Act and laws regulating government contractors may be informed.
W194N11481 McCormick Dr.
Germantown, WI 53022