Employment Application

Why are you being asked to complete this form?

How do you know if you have a disability?

• Autism
• Autoimmune disorder (for example, lupus, fibromyalgia, rheumatoid arthritis, or HIV/AIDS)
• Blind or low vision
• Cancer
• Cardiovascular or heart disease
• Celiac disease
• Cerebral palsy
• Deaf or hard of hearing
• Depression or anxiety
• Diabetes
• Epilepsy
• Gastrointestinal disorders (for example, Crohn's Disease, or irritable bowel syndrome)
• Intellectual disability
• Missing limbs or partially missing limbs
• Nervous system condition (for example, migraine headaches, Parkinson’s disease, or Multiple sclerosis (MS))
• Psychiatric condition (for example, bipolar disorder, schizophrenia, PTSD, or major depression)