Business Application Form

Page 1

Organization Name

Address

Street Address

City

State / Province

ZIP / Postal Code

CEO

Award Application Coordinator's Name

First Name

Last Name

Coordinator's Fax Number

Coordinator's Email Address

Page 2

Please indicate your organization's current workforce composition in the tables below.

Continue with the next category.

Attach any supporting documents for this section.

Attach any necessary documents

Max 10 MB per file

Page 3

Hiring Data

Please indicate the number of employees hired in the most recent period, by category.

Continue with the next category.

Additional Comments

A- What recruitment efforts does your organization use to attract diverse candidates?

Attach any necessary documents

Max 10 MB per file

Page 4

Employee Termination Data

Please indicate the number of employee terminations in the most recent period, by category.

Continue with the next category.

Additional Comments

A- What retention efforts does your organization use to retain diverse employees?

Attach any necessary documents

Max 10 MB per file

Page 5

Diversity and Inclusion Training

Answer the following questions about your organization's training programs.

A. Is diversity and inclusion training required for all employees?

Yes, it's required

If yes, briefly describe the training and how frequently it is provided.

B. Is diversity and inclusion training required for all leaders?

Yes, it's required

If yes, briefly describe the training and how frequently it is provided.

C. Is harassment prevention training required?

Yes, it's required

If yes, briefly describe the training and how frequently it is provided.

D. Does your organization have a succession-planning program?

Yes No

If yes, please describe how this program tracks and provides development opportunities for diverse employees.

E. Describe how your organization creates, promotes, and sustains a positive inclusive environment.

Attach any necessary documents

Max 10 MB per file

Page 6

Supplier Diversity

1- Does your organization have a policy for doing business with diverse suppliers? If so, which of the statements below best describes the current state of your policy?

We have a formal written policy It's an informal practice, not documented Currently in development We do not have a policy

If yes, please describe your policy:

2- Does your organization have a formal plan to implement your policy?

Yes No

If yes, please describe your progress of the formal plan.

3- Has your organization completed any business transactions with diverse suppliers in the past two years? If yes, please complete the table below.

4- What resources has your organization used to find diverse suppliers? Please check all that apply.

Trade associations Diverse supplier directories Referrals Online search Other

If Other, please specify

5- Please share any and all efforts to reach out to our organization vendors/suppliers within our greater organization region that you have not included above.

Attach any necessary documents

Max 10 MB per file

Page 7

Community Involvement

Briefly describe your organization's community initiatives.

1. Community Sponsored Programs.

2. Employee Community Volunteer Hours.

3. Corporate Match Programs.

Attach any necessary documents

Max 10 MB per file

Page 8

Closing Summary

A. What are the top 3 accomplishments that your organization has achieved as it relates to your diversity and inclusion initiatives?

B. Describe how Officials/Managers/Supervisors are held accountable through recruitment, retention, training, and development in relation to diversity and inclusion?

C1. What is unique about your organization overall as related to diversity and inclusion?

C2. What is unique about your organization in comparison to your industry as related to diversity and inclusion?

D. What does your organization do to attract and better serve diverse customers?

Attach any necessary documents

Max 10 MB per file

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