|Information relative to change of name, use of an assumed name or nickname necessary to enable a check on applicant’s work records.||Name|| The fact of a change of name or the original name of an applicant whose name has been legally changed.|
|“Can you, after employment, submit verification of your legal right to work in the United States?” /or/ Statement that such proof may be required after employment.|
Length of applicant’s residence in city where the employer is located.
|“Do you own or rent your home?”|
Birthplace of applicant, spouse or parents.
Requirement that the applicant submit birth certificate, naturalization or baptismal record.
|Statement that hire is subject to verification that applicant meets legal age requirements.|
“If hired, can you show proof of age?”
“Are you over 18 years of age?”
“If under 18, can you, after employment, submit a work permit?”
Dates of attendance or completion of elementary or high school.
Questions which tend to identify applicants over age 40.
|“Can you, after employment, submit verification of your legal right to work in the United States?” /or/ Statement that such proof may be required after employment.||Citizenship||Any inquiry into whether applicant is or intends to become a citizen of the United States.|
Any requirement that applicants produce naturalization or alien registration prior to employment.
Requirement of production of naturalization or alien registration prior to employment.
|Languages applicant reads, speaks, or writes, if use of a language other than English is relevant to the job for which applicant is applying.||National Origin||Questions as to nationality, lineage, ancestry, national origin, descent, or parentage of applicant, applicant’s parents, or spouse.|
“What is your mother tongue?” /or/ Language commonly used by applicant.
How applicant acquired ability to read, write, or speak a foreign language.
|Name and address of parent or guardian if applicant is a minor.|
Statement of company policy regarding work assignment of employees who are related.
Name and address of person to be notified in case of accident or emergency.
|Questions which indicate applicant’s sex.|
Questions which indicate applicant’s marital status.
Number and/or ages of children or dependents.
Provisions for child care or child support obligations.
Questions regarding pregnancy, child bearing, or birth control.
Name or address of relative, spouse, or children of adult applicant.
“With whom do you reside?” or“Do you live with your parents?”
|Race, Color||Questions as to applicant’s race or color.|
Questions regarding applicant’s complexion or color of skin, eyes, hair.
|Statement that photograph may be required after employment.||Physical Description,|
|Questions as to applicant’s height and weight.|
Require applicant to affix a photograph to application.
Request applicant, at his or her option, to submit a photograph.
Require a photograph after interview but before employment.
|Statement by employer that offer may be made contingent on applicant passing a job-related physical examination.|
“Can you perform the essential functions of the job applied for?”
|Physical or Mental Disability||Questions regarding applicant’s general medical condition, state of health, or illnesses.|
Questions regarding receipt of Workers’ Compensation.
“Do you have any physical disabilities or handicaps?”
|Statement by employer of regular days, hours, or shifts to be worked as well as religious days on which operations are closed.||Religion||Questions regarding applicant’s religion.|
Religious days observed /or/ “Does your religion prevent you from working weekends or holidays?”
|Job-related questions about convictions,except those convictions which have beensealed, expunged, or statutorily eradicated.||Arrest, Criminal Record||a. Number and kinds of arrests. Arrest record /or/ “Have you ever been arrested?”|
b. Misdemeanor convictions for possession of marijuana that are more than two years old.
|Questions regarding relevant skills acquired during applicant’s U.S. military service.|
Whether separation from military service was for any reason other than an honorable discharge.
Whether applicant has received any notice to report for duty in the Armed Forces.
|Military Service||General questions regarding military services such as dates, and type of discharge.|
Questions regarding service in a foreign military.
|Any report which would indicate information otherwise illegal to ask, e.g., marital status, age, residency, etc.|
|“Please list job-related organizations, clubs, professional societies, or other associations to which you belong – you may omit those which indicate your race, religious creed, color, disability, marital status, national origin, ancestry, sex, or age.”||Organizations|
|“List all organizations, clubs, societies, and lodges to which you belong.”|
|Names of persons willing to provide professional and/or character references for applicant.|
Names of persons who suggested applicant apply for a position with the employer.
|References||Questions of applicant’s former employers or acquaintances which elicit information specifying the applicant’s race, color, religious creed, national origin, ancestry, physical or mental disability, medical condition, marital status, age, and sex.|
|Name and address of person to be notified in case of accident or emergency.||Notice in Case of Emergency||Name, address, and relationship of relative to be notified in case of accident or emergency.|