WITTENSTEIN North America
WITTENSTEIN North America

Form CC-305
OMB Control Number 1250-0005
Expires 05/31/2023

 

Why are you being asked to complete this form?

We are a federal contractor or subcontractor required by law to provide equal employment opportunity to qualified people with disabilities. We are also required to measure our progress toward having at least 7% of our workforce be individuals with disabilities. To do this, we must ask applicants and employees if they have a disability or have ever had a disability. Because a person may become disabled at any time, we ask all of our employees to update their information at least every five years.

Identifying yourself as an individual with a disability is voluntary, and we hope that you will choose to do so. Your answer will be maintained confidentially and not be seen by selecting officials or anyone else involved in making personnel decisions. Completing the form will not negatively impact you in any way, regardless of whether you have self-identified in the past. For more information about this form or the equal employment obligations of federal contractors under Section 503 of the Rehabilitation Act, visit the U.S. Department of Labor’s Office of Federal Contract Compliance Programs (OFCCP) website at www.dol.gov/ofccp.


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:

  • Autism 
  • Autoimmune disorder, for example, lupus, fibromyalgia, rheumatoid arthritis, or HIV/AIDS 
  • Blind or low vision
  • Cancer 
  • Cardiovascular or heart disease 
  • Celiac disease 
  • Cerebral palsy 
  • Deaf or hard of hearing 
  • Depression or anxiety 
  • Diabetes 
  • Epilepsy
  • Gastrointestinal disorders, for example, Crohn's Disease, or irritable bowel syndrome 
  • Intellectual disability 
  • Missing limbs or partially missing limbs 
  • Nervous system condition for example, migraine headaches, Parkinson’s disease, or Multiple sclerosis (MS) 
  • Psychiatric condition, for example, bipolar disorder, schizophrenia, PTSD, or major depression


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 a 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.

 

Contact Information
Attn: Human Resources
WITTENSTEIN North America
1249 Humbracht Circle
Bartlett, IL  60103

Phone: 630-540-5300
Email: info@wittenstein-us.com