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Applicant Voluntary Self-Identification Form I

Based on certain work it performs, EPAM Systems, Inc., is a government contractor. This means EPAM must comply with certain government contractor regulations relating to equal opportunity and affirmation action. The regulations require that EPAM record U.S. applicants’ gender, ethnicity, and race.  For this reason, we invite you to indicate your gender, ethnicity, and race below. 

Information recorded on these forms will not be shared with those involved in the hiring process. These responses remain completely confidential within our People Management department and will only be used for inclusion in EPAM’s Affirmative Action Program and reporting requirements. When reported, data will not identify specific individuals.

Submission of this information is voluntary and refusal to provide it will not subject you to adverse treatment. If you choose not to provide a response, please select “I choose not to disclose.”

*(The EEOC definitions of race and ethnic categories are included below for reference)

Definition of Rece/Ethnic Categories

Hispanic or Latino: A person of Cuban, Mexican, Puerto Rican, South or Central American or other Spanish Culture or origin regardless of race.

White: A person having origins in any of the original peoples of Europe, the Middle East, or North Africa

Black or African American: A person having origins in any of the black racial groups of Africa

Native Hawaiian or Other Pacific Islander: A person having origins in any of the peoples of Hawaii, Guam, Samoa, or other Pacific Islands

Asian: 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.

American Indian or Alaska Native: A person having origins in any of the original peoples of North and South America (including Central America), and who maintain tribal affiliation or community attachment.


Applicant Voluntary Self-Identification Form II

Based on certain work it performs, EPAM Systems, Inc., is a government contractor. This means EPAM must comply with the Vietnam Era Veterans’ Readjustment Assistance Act of 1974, as amended by the Jobs for Veterans Act of 2002, 38 U.S.C. 4212 (VEVRAA), which requires government contractors to take affirmative action to employ and advance in employment: (1) disabled veterans; (2) recently separated veterans; (3) active duty wartime or campaign badge veterans; and (4) Armed Forces service medal veterans. These classifications are defined as follows:

A “disabled veteran” is one of the following:

  • A veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs; or
  • A person who was discharged or released from active duty because of a service-connected disability.
  • A “recently separated veteran” means any veteran during the three-year period beginning on the date of such veteran’s discharge or release from active duty in the U.S. military, ground, naval, or air service.
  • An “active duty wartime or campaign badge veteran” means a veteran who served on active duty in the U.S. military, ground, naval or air service during a war, or in a campaign or expedition for which a campaign badge has been authorized under the laws administered by the Department of Defense.
  • An “Armed forces service medal veteran” means a veteran who, while serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985.

The law requires that EPAM ask all U.S. applicants to identify whether or not they fall within one of these veteran status classifications. 

Confidentiality:  The information you submit will be kept confidential, except that (i) supervisors and managers may be informed regarding restrictions on the work or duties of disabled veterans, and regarding necessary accommodations; (ii) first aid and safety personnel may be informed, when and to the extent appropriate, if you have a condition that might require emergency treatment; and (iii) government officials engaged in enforcing laws administered by the Office of Federal Contract Compliance Programs, or enforcing the Americans with Disabilities Act, may be informed.

Voluntary: Submission of this information is voluntary and refusal to provide it will not subject you to any negative treatment. The information provided will be used only in order to measure the effectiveness of the outreach and positive recruitment EPAM is undertaking regarding veterans in these classifications. If you chose not to provide a response to any question, please select the “I chose not to disclose” option on the drop-down.

Accommodations: If you are a disabled veteran and require an accommodations to enable you to complete the application process or perform the essential functions of a job your are applying for, including without limitation special equipment, changes in the way a job you are applying for is customarily performed, provision of personal assistance services or other accommodations, please reach out to [email protected] to discuss your needs.

Further rights: Veterans may have additional rights under USERRA—the Uniformed Services Employment and Reemployment Rights Act. In particular, if you are absent from employment in order to perform service in the uniformed service, you may be entitled to be reemployed by your employer in the position you would have obtained with reasonable certainty if not for the absence due to service. For more information, call the U.S. Department of Labor’s Veterans Employment and Training Service (VETS), toll-free, at 1-866-4-USA-DOL.

Please complete the following questionnaire to move to the next screen:


Applicant 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. 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 answers will not be used against you in any way.  Because a person may become disabled at any time, we are required to ask all 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
  • Deafness
  • Cancer
  • Diabetes
  • Epilepsy
  • Autism
  • Cerebral palsy
  • Schizophrenia
  • Muscular dystrophy
  • Bipolar disorder
  • Major depression
  • Multiple sclerosis (MS)
  • Missing limbs or partially missing limbs
  • Post-traumatic stress disorder (PTSD)
  • Obsessive compulsive disorder
  • Impairments requiring the use of a wheelchair
  • Intellectual disability (previously called mental retardation)

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. 


iSection 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 U.S. 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.

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