||NOT RECOMMENDED |
Are you 18 years of age or older? If not, state your age.
| How old are you? What are the ages of your children, if any?|
| Arrest Record
|| Have you ever been convicted of a criminal offense? (Give details)
|| Have you ever been arrested?|
|| Do you have a disability? Have you ever been treated for any of the following diseases . . .? Do you have now, or have you ever had, a drug or alcohol problem?|
| Genetic Predisposition or Carrier Status
|| Do you have any genetic predisposition to disease? Do any diseases run in your family? Inquiries as to the health status of parents or other family members. |
Is your spouse employed by this employer?
| Do you wish to be addressed as Miss? Mrs.? Ms.? Are you married? Single? Divorced? Separated? Name or other information about spouse.|
| National Origin
Inquiry into applicant's lineage, ancestry, national origin, descent, parentage or nationality. Nationality of applicant's parents or spouse.
| Sexual Orientation
Inquiries as to sexual orientation. Are you married or single? Do you have a girlfriend/boyfriend? Requirement that applicant produce any document that would reveal marital status.
| Race or Color
|| Complexion or color of applicant's skin, eyes, hair, and so forth.|
|| Inquiry into applicant's religious denomination, religious affiliations, house of worship, religious holidays observed.|
|| Inquiry as to gender. Inquiries as to capacity to reproduce, use of any form of birth control or family planning.|
| Address or Duration of Residence
|| Applicant's place of residence. How long a resident of this state or city?
|| How long have you lived in this country? In what country did you live before? |
|| Requirement that applicant submit birth certificate, naturalization or other record showing age. Requirement that applicant produce proof of age in form of birth certificate or other record.|
|| Inquiries as to birthplace of applicant or birthplace of applicant's parents, spouse or other relatives. |
|| Are you a citizen of the United States? If not a citizen of the United States , do you intend to become a citizen of the United States? If you are not a United States citizen, have you the legal right to remain permanently in the United States? Do you intend to remain permanently in the United States?
|| Of what country are you a citizen? Inquiries as to whether an applicant or an applicant's parents or spouse are naturalized or native-born citizens; requirement that applicant produce naturalization papers. |
| Driver's License
|| Do you possess a valid NYS driver's license (if a driver's license is necessary for the position applicant is seeking)?
|| Requirement that applicant produce license prior to offer of employment.|
|| Inquiry into applicant's academic, vocational or professional education and the public and private schools attended.
|| Year(s) of attendance; Date(s) of graduation.|
| Inquiry into work experience. If the duties of the position applicant is seeking require fluency in a particular language, inquiry may be made into whether applicant speaks or writes that language fluently.
|| What is your native language? Inquiry into how applicant acquired ability to read, write or speak a foreign language.|
| Military Experience
|| Inquiry into applicant's military experience in the Armed Forces of the United States or in a State Militia. Inquiry into applicant's service in a particular branch of the United States Army, Navy, etc.
|| Inquiry into applicant's military experience other than in the Armed Forces of the United States or in a State Militia.|
|| Have you ever worked for this company under a different name? Is additional information relative to change of name, use of an assumed name or nickname necessary to enable check on your work records? If yes, explain.
|| Inquiries as to original names of an applicant whose name has been changed by court order or otherwise. Inquiries as to the birth name of a married woman. If you have ever worked under another name, state name and dates.|
| Notice In Case of Emergency
|| Requirement that applicant provide name and address of relative to be notified in case of an accident or emergency.|
|| Inquiry into applicant's membership in organizations which the applicant considers relevant to his or her ability to perform the job.
|| Requirement that applicant list all clubs, societies, and lodges to which applicant belongs. |
|| Requirement or option that applicant affix a photograph to employment form at any time before hiring.|
|| Inquiry as to names of applicant's relatives already employed by the company.
|| Inquiry as to names, addresses and ages of applicant's spouse, children or relatives not employed by the company. |