Information below must match legal documentation (i.e. I-9 or Social Security Card).
Date of Birth
Date of Hire
Have you ever applied to GW as a student?
Have you been affiliated with GW before?
(e.g. as a student, faculty or staff member, affiliate)
GWID (If known)
Are you currently a GW student?
Other name you may have had while previously affiliated with GW
Employment Eligibility Status
Colleges and universities are asked by many, including the federal government, accrediting associations, college guides, and our own college/university communities, to describe the ethnic/racial backgrounds of their students and employees. In order
to respond to these requests, we ask that you answer the following two questions on ethnicity and race.
1. Do you consider yourself to be Hispanic or Latino? (Persons of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race)
2. In addition, you may select one or more of the following racial categories to describe yourself:
If both Vietnam/other eligible veteran, date of separation:
Month Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Year 2019 2020 2021 2022 2023
*If other disability status, please list
If you need a reasonable accommodation, contact the EEO Department to make your request.
Are any relatives or members of your household currently employed with GW?
Relationship to you
Relationship to you 2
Address and Emergency Contact Information
(Address of primary office, if known)
Name of your department
Campus Street Address
Campus Address City
Campus Address Zip Code
Campus Phone Number
Home Street Address
Home Zip Code
Home Email Address
Emergency Contact Information
Emergency Contact Name
Relationship to You
Contact Street Address
Contact Zip Code
Contact Phone Number
Please report any changes to the information listed above to Human Resource Management and Development.
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