Office of Social Equity Pre-Employment Inquiry

Pre-Employment Inquiry Form

Dear Applicant:

We appreciate your interest in employment with the University.  This online form is to be used by recent applicants only.  Please do not fill it out unless you have already applied and sent your resume/vita.

As an equal opportunity institution, the University has a continuing nondiscrimination policy which prohibits discrimination in employment and services based on race, creed, color, sex, sexual orientation, religion, national origin, age, disability or veteran's status.

In accordance with federal guidelines and regulations, the University is required to gather and report affirmative action data to monitor the success of our recruitment efforts.

You will greatly assist us in meeting Federal and University requirements by completing this form below, which for your convenience is electronically reported immediately to the Office of Social Equity.  The information will be used only for statistical purposes in connection with the University's voluntary social equity efforts.  Failure to provide this information will not adversely affect your candidacy.

Thank you again for your interest in California University of Pennsylvania and for assisting us in meeting reporting requirements.

Sincerely,

Lenora A. Angelone
Special Assistant to the President for
EEEO/University Ombudsperson 

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*** You must have a Vacancy Number or FPA in order to process this form.  Also, you must provide your name, the department, and the title and position of which you are applying.

Last Name:		First Name:
FPA/Vacancy #		Title/Position Applied for:		Department:
RACE/ETHNICITY
	White (not of Hispanic Origin). A person having origins in any of the original peoples of Europe, North Africa, or the Middle East.
	Black (not of Hispanic Origin). A person having origins in any of the Black racial groups of Africa.
	Hispanic. A person of Mexican, Puerto Rican, Cuban, Central or South American or other Spanish culture or origin.
	Asian or Pacific Islander. A person having origins in any of the original peoples of the Far East, Southeast Asia, the Indian Sub-continent, or the Pacific Islands. The area includes, for example, China, Japan, Korea, the Phillipine Islands, and Samoa.
	American Indian or Alaskan Native. A person having origins in any of the original peoples of North America, and who maintains cultural identification through tribal affiliation or community recognition.
Gender	Male	Female	If not U.S. Citizen, are you authorized to work in the U.S.A.? (explain status below)
Veteran	Yes	No
U.S. Citizen	Yes	No
Where did you learn about this position?
	CUP Website
	Chronicle of Higher Ed
	Courier
	Academic Careers
	HigherEdJobs.com
	AJP/PA Job Bank
Other: