Emboldly Team Application Name * First Name Last Name What are your pronouns? * Email * Phone * (###) ### #### Country of residence * US region * Northeast US Southeast US South US Midwest US Pacific US Not located in the US City and state of residence * Enter as City, ST (e.g., Austin, TX) Current company and role * Enter as Company; Role (e.g., McKinsey & Co; Business Analyst) University, major(s), and grad year * Enter as University; Major; Grad Year (e.g., University of Texas at Austin; Finance; 2022) LinkedIn * http:// Open roles I am applying for (select all you are applying for) * Ensure you meet qualifications the roles by viewing the role descriptions at this link: https://www.emboldly.org/open-roles Chief development officer Social media manager Program manager Program coordinator - Workplace Interventions Program coordinator - Events Editor in Chief Writer Research analyst Outreach coordinator Financial coordinator Other Do you understand this is an unpaid role? * Yes No U.S. EQUAL EMPLOYMENT OPPORTUNITY INFORMATION (Completion is voluntary and will not subject you to adverse treatment) * Emboldly provides equal employment and affirmative action opportunities to applicants and employees without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, or disability. We invite all applicants to voluntarily self-identify their race, ethnicity, and gender. Submission of the information on this form is strictly voluntary and refusal to provide it will not subject you to any adverse treatment. Information obtained will be retained in a confidential file and separate from personnel records. This information may only be used in accordance with the provision of applicable federal laws, executive orders, and regulations. If you want more information about any of the sections, please check with a company representative. Yes No Gender Male Female Nonbinary Decline to self-indentify What is your race/ethnicity? Please select all that apply * American Indian or Alaska Native Asian Black or African American Hispanic or Latinx Native Hawaiian/ Other Pacific Islander White Other Prefer not to answer SELF-IDENTIFICATION OF VETERAN STATUS (Completion is voluntary and will not subject you to adverse treatment) I am a vetran I am not a veteran I decline to self-identify VOLUNTARY SELF-IDENTIFICATION OF DISABILITY Yes, I have a disability or have had one in the past No, I do not have a disability or have had one in the past I do not want to answer Thank you for applying to Emboldly. We’ll be in touch soon with next steps!