Please fill in the one response that best applies to you for each item in the following section.

In accordance with the federal government's uniform guidelines to ensure non-discriminatory testing, we ask you to voluntarily supply the following information. This information will be used for Equal Employment Opportunity research purposes only. Individual data will not be shared with the prospective employer.

Race/Ethnicity:

Age:

• I agree to complete the survey without assistance from others
• I agree to answer all questions honestly.
• I authorize you to score my responses.
• I grant permission to share my results with the potential employer.
• I understand that the results will not be shared with me.
• I agree not to disclose, copy or distribute any portion of the Survey.

I Accept