Form B: Affirmative Action Report

AA SEARCH # _______________________

Before an offer of employment can be made, the search committee chairperson must complete this form and return it to the Office of Social Equity.

1. Department: ____________________________________________________________

2. Position Advertised: _______________________________________________________

3. Date First Advertised: __________________________       4. Closing Date:____________

5.  Position advertised where? (Attach Recruiting Strategy)

6.  Number of applicants by race:    Black ____   Caucasian ____    Latino ____   

Asian/Pacific Islander ____   Native American or Native Alaskan ____   Other _______   Total number ____

7.  Number of qualified* applicants by race:   Black ____   Caucasian ____   Latino ____   

Asian/Pacific Islander ____   Native American or Native Alaskan ____   Other _______   Total number ____

8.  Number of applicants by gender:   female ____   male ____   total number ____

9.  Number of qualified* applicants by gender:    female ____   male ____   total number ____

10.  Applicants interviewed by race:

       Black ____   Caucasian ____   Latino ____   Asian/Pacific Islander ____ 

       Native American or Native Alaskan ____   Other _______         Total number ____

11.   Applicants interviewed by gender (on campus):   female ____   male ____   total number ____

12.   Person employed:   Name ________________________________   race ____________  gender _______

13.    Person filing this report: _______________________________  Date: ______________

*Qualified:  Those applicants meeting all posted minimum requirements.