Office of Equal Opportunity
Applicant Affirmative Action Survey

 

Completion of the information below is voluntary.  Please check the boxes which apply and complete the appropriate sections.  This information will be used in the development of affirmative action reports and recruitment strategies.  No identifiable information will be shared with those individuals making hiring decisions or any subsequent employment decisions.  Thank you for participating in this survey and please take a moment to check out The University of Maine website.

 

 Date:    (Example: 1/12/02)

 Position ID:        

Title of Position Applied for:

Department:

Sex:

Name (Optional):

Racial/Ethnic Group:

Please check one:

I am not a Veteran

I am a Vietnam-era veteran

I am a disabled Vietnam-era veteran.

I am a disabled veteran.

Other veteran

How did you learn about the position for which you are applying? :

Please indicate the name of the publication, listserv, website or group:

Do you have a disability?  Check the one answer that best applies: Yes No

Do you need accommodations to participate in the application process? Yes No

If yes, please contact our Office at 207-581-1226 or e-mail bgrindle@maine.edu.

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