Bold Page Profile
- Autoimmune disorder, for
- Example, lupus, fibromyalgia
- Rheumatoid arthritis, HIV/AIDS
- Blind or low vision
- Cancer (past or present)
- Cardiovascular or heart
- Disease
- Celiac disease
- Cerebral palsy
- Deaf or serious difficulty
- Hearing
- Diabetes
- Disfigurement, for example
- Disfigurement caused by burns
- Wounds, accidents, or congenital
- Disorders
- Epilepsy or other seizure disorder
- Gastrointestinal disorders, for example
- Crohn's Disease, irritable bowel
- Syndrome
- Intellectual or developmental disability
- Mental health conditions, for example
- Depression, bipolar disorder, anxiety
- Disorder, schizophrenia, PTSD
- Missing limbs or partially missing limbs
- Mobility impairment, benefiting from the
- Use of a wheelchair, scooter, walker
- Leg brace(s) and/or other supports
- Nervous system condition, for example
- Migraine headaches, Parkinson’s
- Disease, multiple sclerosis (MS)
- Neurodivergence, for example
- Attention-deficit/hyperactivity disorder
- Voluntary Self-Identification of Disability
- Form CC-305 OMB Control Number 1250-0005
- Page 1 of 1 Expires 04/30/2026
- Name: Date:
- Employee ID:
(if applicable)
- Why are you being asked to complete this form?
- We are a federal contractor or subcontractor
- The law requires us to provide equal employment opportunity to qualified
people with disabilities
- We have a goal of having at least 7% of our workers as people with disabilities
- The law says we
must measure our progress towards this goal
- To do this, we must ask applicants and employees if they have a disability
or have ever had one
- People can become disabled, so we need to ask this question at least every five years
- Completing this form is voluntary, and we hope that you will choose to do so
- Your answer is confidential
- No one who
makes hiring decisions will see it
- Your decision to complete the form and your answer will not harm you in any way
- If you
want to learn more about the law or this form, visit the U.S
- Department of Labor’s Office of Federal Contract Compliance
- Programs (OFCCP) website at www.dol.gov/ofccp
- How do you know if you have a disability?
- A disability is a condition that substantially limits one or more of your “major life activities.” If you have or have ever had
such a condition, you are a person with a disability
- Disabilities include, but are not limited to:
- Alcohol or other substance use
disorder (not currently using
drugs illegally)
