Position: Future Opportunities
Location: Owatonna
Job Code: 140

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Personal Information

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Voluntary Equal Opportunity Questionnaire

Gopher Sport is an Equal Opportunity / Affirmative Action Employer.  We comply with all applicable laws governing employment practices and do not discriminate on the basis of any unlawful criteria such as race, religion, creed, national origin, citizenship, color, gender, sexual orientation, marital status, age, mental or physical disability, veteran status or any other similarly protected status.
We invite you to complete the optional self-identification fields below used for compliance with government regulations and record-keeping.  Providing this information is VOLUNTARY.  Failure to provide it will not subject you to any adverse hiring decision or action.  The survey is not part of your official application for employment.  The information will be kept confidential in accordance with applicable laws and regulations.

Voluntary Self-Identification of Disability

Form CC-305   
OMB Control Number 1250-0005   
Expires 1/31/2020   

Why are you being asked to complete this form?

Because we do business with the government, we must reach out to, hire, and provide equal opportunity to qualified people with disabilities.i To help us measure how well we are doing, we are asking you to tell us if you have a disability or if you ever had a disability. Completing this form is voluntary, but we hope that you will choose to fill it out. If you are applying for a job, any answer you give will be kept private and will not be used against you in any way.

If you already work for us, your answer will not be used against you in any way. Because a person may become disabled at any time, we are required to ask all of our employees to update their information every five years. You may voluntarily self-identify as having a disability on this form without fear of any punishment because you did not identify as having a disability earlier.

How do I know if I have a disability?

You are considered to have a disability if you have a physical or mental impairment or medical condition that substantially limits a major life activity, or if you have a history or record of such an impairment or medical condition. Disabilities include, but are not limited to:

• Blindness• Cerebral palsy• Multiple sclerosis (MS)
• Deafness• HIV/AIDS• Missing limbs or partially missing limbs
• Cancer• Schizophrenia• Post-traumatic stress disorder (PTSD)
• Diabetes• Major depression• Obsessive compulsive disorder
• Epilepsy• Bipolar disorder• Impairments requiring the use of a wheelchair
• Autism• Muscular dystrophy• Intellectual disability (previously called mental retardation)

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Reasonable Accommodation Notice

Federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. Please tell us if you require a reasonable accommodation to apply for a job or to perform your job. Examples of reasonable accommodation include making a change to the application process or work procedures, providing documents in an alternate format, using a sign language interpreter, or using specialized equipment.
i Section 503 of the Rehabilitation Act of 1973, as amended. For more information about this form or the equal employment obligations of Federal contractors, visit the US. Department of Labor's Office of Federal Contract Compliance Programs (OFCCP) website at
PUBLIC BURDEN STATEMENT: According to the Paperwork Reduction Act of 1995 no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. This survey should take about 5 minutes to complete.

Legal Statement

I hereby certify that all of the information provided by me in this application (or any other accompanying or required documentation) is correct, accurate and complete to the best of my knowledge. I understand that the falsification, misrepresentation or omission of any facts in said documents will be cause for denial of employment or immediate termination of employment regardless of the timing or circumstances of discovery.
I understand that submission of an application does not guarantee employment. I further understand that, should an offer of employment be extended by Gopher Sport that such employment is at will, for no specified duration and may be terminated by either Gopher Sport or myself at any time, with or without cause or notice. I understand that none of the documents, policies, procedures, actions, statements of Gopher Sport or its representatives used during the employment process is deemed a contract of employment real or implied.
In consideration for employment with Gopher Sport, if employed, I agree to conform to the rules, regulations, policies and procedures of Gopher Sport at all times and understand that such obedience is a condition of employment. I understand that due to the nature of Gopher Sport business, attendance and punctuality are considered essential requirements of every job at Gopher Sport and that poor attendance or tardiness will result in disciplinary action.
I understand that, as an applicant for a position with Gopher Sport, I may be asked to demonstrate that I am capable of performing tasks which are pertinent to the job and submit to pre-employment testing and/or a background investigation. I also understand that if offered a job, it is contingent upon the successful completion of a drug test and my ability to provide documentation necessary to establish identity and eligibility to work in the United States. I understand that unsatisfactory results from, refusal to cooperate with, or any attempt to affect the results of these pre-employments tests and checks will result in withdrawal of any employment offer or termination of employment if already employed.
I herby authorize any and all schools, former employers, references, courts and any others who have information about me to provide such information to Gopher Sport and/or any of its representatives, agents or vendors and I release all parties involved from any and all liability for any and all damage that may result from providing such information.



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