Affirmative Action/Equal Employment Opportunity Data

The following information is requested to comply with federal reporting requirements. The information is necessary for statistical analysis of applicant flow data in administering the campus equal opportunity/affirmative action program. Furnishing the information is voluntary; there is no penalty for not providing it. The information is not forwarded to the search committee, and it is not included for review in the application material.

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* 1. Applicant name:

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* 2. Position applied for:

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* 3. Gender:

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* 4. Ethnic Background (please choose the ethnic group with which you most identify):

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* 5. Diability/Veteran Status (select all that apply):

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* 6. Referral Source: 

To help us more effectively recruit candidates for open positions, please identify the specific source(s) where you learned of this opportunity.  Please name or describe the source(s) in the appropriate field(s) as they apply to you. If your source(s) is not specified below, please provide it in the 'other' field.

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