Voluntary Affirmative Action Survey

Completion of this Form is Voluntary. Arkansas State University is an Equal Opportunity / Affirmative Action employer. We consider all qualified applicants for all positions without regard to race, color, religion, gender, national origin, age, disability or any other legally protected status. We also comply with all applicable laws governing employment practices and do not discriminate on the basis of any unlawful criteria.

This information is used in an effort to comply with required record keeping and to ensure that our requirement efforts reach all segments of the population. This information will not be considered with your application and will remain in a separate confidential file.

Again, this information is provided on a voluntary basis. Not providing this information will not affect your application with ASU. Thank you for your assistance.

Applicant Name:
Position Applied For:
Position Number: (Note: This number is provided on the job posting.)

Gender:

Male Female I choose not to disclose

Ethnicity: If you are Hispanic or Latino, please check this box:

Race:  If you did not select the Hispanic/Latino box, please check one of the Race categories:

Asian
Black/African American
American Indian/Alaskan Native
Native Hawaiian/Pacific Islander
White
Two or more races
Not disclosed

Any questions regarding ASU’s Equal Opportunity / Affirmative Action Policy should be addressed to the Affirmative Action Program Coordinator at (870) 972-3658.