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Get IL Per D 173.5 2014

complete and return the EEO Request form with your employment application. Mark only one selection for both race and disability. • Completion or omission of this information is voluntary and will in no way affect employment opportunities with the Office of the Secretary of State. • This form will be maintained in a separate file with the Department of Personnel and will not be kept with the graded employment application. Name:________________________________________________________ Dat.

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