Voluntary Application Supplement | Hagerstown Community College

Name:

Position(s) you are applying for: *

Gender:

Male

Female

Race of Ethnicity:

American Indian or Alaskan Native - A person having origins in any of the original peoples of North and South America (including Central America) who maintains tribal affiliation or community attachment.

Asian - A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian Subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.

Black or African American - A person having origins in any of the black racial groups of Africa.

Native Hawaiian or Other Pacific Islander - A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.

Hispanic of Latino - A person of Cuban, Mexican, Puerto Rican, South American or Central American, or other Spanish culture or origin.

White - A person having origins in any of the original peoples of Europe, the Middle East or North Africa.

Disabled/Veteran Classification(s):

Disabled Veteran - (i) a veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs, or (ii) a person who was discharged or released from active duty because of a service-connected disability.

Special Disabled Veteran - (i) a veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Department of Veterans' Affairs for a disability (A) rated at 30% or more, or (B) rated at 10 or 20% in the case of a veteran who has been determined under Section 38 U.S.C. 3106 to have a serious employment handicap or (ii) a person who was discharged or released from active duty because of a service Veteran of the Vietnam era: a person who: (i) served on active duty in the U.S. military, ground, naval or air service for a period of more than 180 days, and who was discharged or released there from with other than a dishonorable discharge, if any part of such active duty was performed: (A) in the Republic of Vietnam between February 28, 1961, and May 7, 1975; or (B) between August 5, 1964, and May 7, 1975, in all other cases; or (ii) was discharged or released from active duty in the U.S. military, ground, naval or air service for a service connected disability if any part of such active duty was performed (A) in the Republic of Vietnam between February 28, 1961, and May 7, 1975; or (B) between August 5, 1964, and May 7, 1975, in any other location.

Disabled Person—Federal regulations define a disabled person as one who (1) has a physical or mental impairment which substantially limits one or more person’s major life activities, (2) has a history of such impairment or (3) is regarded as having such impairment.

For MD State reporting purposes, please state D.O.B: