Cosmos Broadcasting Corporation
Applicant Profile Data Form
We request this information in order to meet EEO requirements of the Federal Communications Commission. It will be maintained in a file separate from your application and will not be considered in connection with your application. Please complete and check items applicable to you.
B. Vacancy applied for (Job Title): ________________________________________________
D. q White, not of Hispanic Origin - A person having origins in any of the original peoples of
Europe, North Africa, or the Middle East.
q Black, not of Hispanic Origin - A person having origins in any of the black racial groups of Africa.
q Hispanic - A person of Mexican, Puerto Rican, Cuban, Central or South American or other Spanish culture of origin, regardless of race.
q Asian or Pacific Islander - A person having origins in any of the original peoples of the Far East, Southeast Asia, the Indian Subcontinent, or the Pacific Islands. This area includes, for example, China, Japan, Korea, the Philippine Islands, and Samoa.
q American Indian or Alaskan Native - A person having origins in any of the original peoples of North America, and who maintains cultural identification through tribal affiliation or community recognition.
F. What prompted you to apply? (Please check the primary reason only.)
q Advertisement q Employee Referral q School
q Agency q Non-Employee Referral q Self
q Community Organization q Other _____________________