CONTACT INFORMATION FORM
TO BE COMPLETED BY INDIVIDUALS SEEKING EMPLOYMENT
IN HOURLY PRODUCTION / NON-CRAFT JOBS
The information requested below is to enable Ford Motor Company representatives to contact you regarding
potential hourly production / non-craft job opportunities, in the event that such opportunities arise.
Please clearly print the requested information, and sign and date this form.
Last Name _____________________________________________________________________________________________
First Name ___________________________________________________________________
Middle Initial _________
Social Security Number _________________________________________________________________________________
Address – Number and Street ____________________________________________________________________________
City _______________________________________________________
State __________
Zip Code _______________
Telephone Number (include Area Code) ____________________________________________________________________
Alternate Telephone Number, if any (include Area Code) ______________________________________________________
Signature ________________________________________________________
Date ____________________________
FORD MOTOR COMPANY IS AN EQUAL OPPORTUNITY EMPLOYER
COMMITTED TO A CULTURALLY DIVERSE WORKFORCE
-- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - FOR FORD MOTOR COMPANY USE ONLY
Company Location _____________________________________________________________________________________________________________
Form Control Number _______________________________________________
Date Completed Form Returned _____________________________
Recruitment Source ____________________________________________________________________________________________________________
VOLUNTARY BACKGROUND INFORMATION FORM
TO BE COMPLETED BY INDIVIDUALS SEEKING EMPLOYMENT
IN HOURLY PRODUCTION / NON-CRAFT JOBS
The following VOLUNTARY information is requested for the purpose of preparing periodic reports to the government or other
recordkeeping in connection with government requirements. We encourage you to complete this form, but your opportunity for
employment will not be adversely affected should you choose not to complete this form. This form will be maintained separately
from your employment application and will not be considered in the application process.
Please print
Last Name _____________________________________________________________________________________________
First Name ___________________________________________________________________
Middle Initial _________
Please refer to the categories and definitions below, and check one box.
GENDER / RACE / ETHNIC CATEGORIES
A
B
C
I
E
K
□
□
□
□
□
□
Hispanic or Latino Male
D
Hispanic or Latino Female
J
White Male
F
White Female
L
Native Hawaiian or Pacific Islander Male
G
Native Hawaiian or Pacific Islander Female
M
H
N
□
□
□
□
□
□
□
□
Black or African American Male
Black or African American Female
Asian Male
Asian Female
American Indian / Alaska Native Male
American Indian / Alaska Native Female
Two or More Races Male
Two or More Races Female
DEFINITIONS
A&B
Hispanic or Latino: a person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin,
regardless of race.
C & I White (Not Hispanic or Latino): a person having origins in any of the original peoples of Europe, the Middle East, or North Africa.
D & J Black or African American (Not Hispanic or Latino): a person having origins in any of the black racial groups of Africa.
E & K Native Hawaiian or Other Pacific Islander (Not Hispanic or Latino): a person having origins in any of the original peoples of
Hawaii, Guam, Samoa, or other Pacific Islands.
F & L Asian (Not Hispanic or Latino): a person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian
subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and
Vietnam.
G & M American Indian or Alaska Native (Not Hispanic or Latino): a person having origins in any of the original peoples of North and
South America (including Central America) and who maintains tribal affiliation or community attachment.
H & N Two or More Races (Not Hispanic or Latino): all persons who identify with more than one of the above five races.
---------------------------------------------------------------------------FOR FORD MOTOR COMPANY USE ONLY
Company Location ____________________________________________________________________________________________________________
Form Control Number _______________________________________________
Date Completed Form Returned ____________________________