Interim Report
Faculty, Administrative, and other Non-classified Positions
Office of Affirmative Action
Position Number: ____________ Position Title: _________________________________ Department: _____________________Date applications closed: ______________
Screening and selection process to be used: __________________________________________________________________________________________________________________________
Type of Appointment:
Adjunct ________ Visiting ________ Tenure ________ Tenure Track ________ Non-Tenure Track ________ Part-time ________ Full-time ________
Please Complete Columns A Through F
Column C – Rating Column F – Action Column G - Race
A. Met all required and preferred qualifications 1. Incomplete Application 1. Black or African American
B. Met all required and some preferred qualifications 2. Applicant withdrew from consideration 2. American Indian or Alaskan Native
C. Met all required, but no preferred qualifications 3. Request approval to interview applicant 3. Asian
D. Met some required, and some preferred qualifications 4. Late Application/Not Considered 4. Hispanic
E. Met some required, but no preferred qualifications Don’t wish to interview – Leave Blank 5. White
F. Met neither required, nor preferred qualifications 6. Native Hawaiian/Pacific Islander
A B C D E F (To be completed by the Affirmative Action Officer)
NAME
(List alphabetically)
Last name, first name
DATE
application
received
RATING
YEARS
Related
experience
GENDER
ACTION
RACE CODE
DISABILITY
VETERAN
STATUS
SOURCE
of Recruitment
Approval: __________________________________ Date: __________________
(Office of Affirmative Action)
