The college is strongly committed to equal opportunity and affirmative action in its
educational programs, as well as hiring of faculty and staff members. Because of our
commitment, it is important that we conduct a careful evaluation of our recruitment efforts
when openings become available within the institution.
In order to comply with federal laws and to assure our affirmative action objectives, we
must collect and analyze the information requested on the following form. We fully
realize that supplying the requested information is voluntary on your part. However, we
urge you to assist us in gathering this vital information. Safeguards have been instituted to
ensure that the information cannot be used as a basis for discrimination during hiring.
Your cooperation in supplying this information is greatly appreciated.
The information being provided below is for information and reporting purposes
only. This information will not be used for hiring purposes.
EQUAL OPPORTUNITY INFORMATION FORM
Position Applied For: _______________________________________________
Name: ________________________________ Age: _____ Sex: ___M ___ F
_____ White, Non-Hispanic or Latino
_____ Black, Non-Hispanic or Latino
_____ Hispanic or Latino
_____ Native Hawaiian or Pacific Islander (Not Hispanic or Latino)
_____ Asian (Not Hispanic or Latino)
_____ American Indian or Alaskan Native (Not Hispanic or Latino)
_____ Two or More Races (Not Hispanic or Latino)
VETERAN STATUS: Are you a disabled veteran? ___ Yes ___ No
Vietnam Era veteran? ___ Yes ___ No
How did you hear of this position? _____________________________________
(If through an advertisement, please name the publication in which is appeared)
Thank you for your assistance.
Shawnee Community College is an Equal Opportunity/Affirmative Action Institution. Women and
minorities are encouraged to apply.