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REGISTRATION FORM

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Professional Support, Inc. is an equal opportunity employer committed to the policies and principles of non-discrimination and affirmative action. In order to respond properly to reporting requirements of federal and state governments, it is important that we maintain a correct information database. Providing this information is optional. Not filling out this section will not, in any way, preclude you from employment consideration.

 
 
White (Not Hispanic or Latino) - All persons having origins in any of the original peoples of Europe, North Africa or the Middle East.

Black or African American (Not Hispanic or Latino) - All persons having origins in any of the Black racial groups of Africa.

Hispanic or Latino - All persons of Mexican, Puerto Rican, Cuban, Central or South American or other Spanish culture or origin, regardless of race.
Asian (Not Hispanic or Latino) - All persons having origins in any of the original peoples of the Far East, Southeast Asia or the Indian Subcontinent. This area includes, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.

Native Hawaiian or Other Pacific Islander (Not Hispanic or Latino) - All persons having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.

American Indian or Alaskan Native (Not Hispanic or Latino) - All persons having origins in any of the original peoples of North or South America (including Central America), and who maintain tribal affiliation or community attachment.

If you checked two or more ethnicities above, please tell us, on the line below, the race with which you primarily identify:

The information from this form, as well as the form itself, will be kept in the strictest of confidence.