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Employment Equity Voluntary Self-Identification Form


If you identify as a member of any of the following designated groups, please select yes for all that apply to you. 

(NOTE: You may self-identify in more than one category below, if applicable.)

(This question is mandatory)
Please tell us your name


For the purposes of employment equity, women are a designated group.

Do you identify as a woman?

African Nova Scotian

African Nova Scotians make up the largest racially visible group in Nova Scotia. Individuals who identify as African Nova Scotian include individuals who were born in Nova Scotia (80.7 percent), individuals who were born elsewhere in Canada (6.7 percent), and new Canadians coming primarily from Africa, the Caribbean, and the United States (10 percent).

Do you identify as African Nova Scotian?

Visible Minority

A member of a visible minority/racialized group in Canada is someone (other than an Aboriginal person as defined in Part C below) who self-identifies as non-white in colour or non-Caucasian in racial origin, regardless of birthplace or citizenship. Members of ethnic or national groups (such as Portuguese, Italian, Greek, etc.) are not considered to be racially visible unless they also meet the criteria above. Visible minority/racialized group members in Canada include, but are not limited to, those individuals who identify as non-white in colour or non-Caucasian in racial origin, and belong to one of the following;

Black (e.g., African, American, Canadian, Caribbean); Chinese; Filipino; Japanese; Korean; Indigenous persons from outside North America; South Asian/East Indian (e.g., Bangladeshi, Pakistani, Indian from India, East Indian from Guyana, Trinidadian, Sri Lankan, East African); South East Asian (e.g., Burmese, Cambodian/Kampuchean, Laotian, Malaysian, Thai, Indonesian, Vietnamese); non-white West Asian (e.g., Iranian, Lebanese, Afghan); non-white North African (e.g., Egyptian, Libyan); Arab; non-white Latin American (including indigenous persons from Central and South America); persons of mixed ancestry (with at least one parent in one of the visible minority groups listed above).

Do you consider yourself a member of a visible minority/racialised group in Canada?

Person with a disability

A person with a disability has a long-term or recurring physical, mental, sensory, psychiatric and/or learning disability and considers their self to be disadvantaged in employment by reason of that disability, or believes that an employer or potential employer is likely to consider them to be disadvantaged in employment by reason of that disability. A person with a disability may also be someone whose functional limitations owing to their disability have been accommodated in their current job or workplace. Disabilities can include: deaf, deafened, and/or hard of hearing; blind and/or low vision; speech disability (e.g., stuttering); physical, functional and/or mobility disability (e.g., arthritis, paraplegia, cerebral palsy, muscular dystrophy, spinal cord injuries, spina bifida); chronic medical condition (e.g., diabetes, chronic pain, HIV/AIDS, chronic fatigue syndrome, kidney disease, seizure disorders); learning disability (e.g. dyslexia); developmental disability (e.g., Asperger Syndrome, Autism, fetal alcohol effect); psychiatric disability and/or mental health disability (e.g., bipolar disorder, obsessive compulsive disorder).

Do you consider yourself to be a person with a disability?

Aboriginal Person

An Aboriginal person is a North American Indian, Métis or Inuit, or a member of a North American First Nation. An Aboriginal person may be a treaty, status or a non-status, registered or non-registered Indian.

Do you consider yourself an Aboriginal Person?

Sexual Orientation

Sexual Orientation is a personal characteristic that covers the range of human sexuality from gay and lesbian to bisexual and heterosexual orientations. Sexual orientation is different from gender identity. It can include emotional attachment, sexual attraction, sexual behaviors, and often identification with a particular culture (e.g., lesbian, gay, bisexual, transsexual, queer, two-spirited, or heterosexual culture).

Do you self-identify as a person whose sexual orientation is other than heterosexual?

Gender Identity

Gender Identity refers to the self-image or understanding of one’s gender as being female, male, androgynous, or something else (e.g., third, fourth gender). Gender identity may differ from assigned sex and, if so, the individual may be considered to be trans. Gender identity differs from sexual orientation, and trans people may be heterosexual, lesbian, gay, or bisexual.

Do you identify as a person whose gender is other than that assigned to you at birth?