Position No. _____________
EEO-AFFIRMATIVE ACTION
This form is to be submitted with
the recommendation for appointment.
Candidates interviewed for the
position should be listed in rank order.
Department/School:
_______________________________________________________________
Position Title:
____________________________________________________________________
Name Highest Degree Gender Race
1. _________________________________________________________________________
2. _________________________________________________________________________
3. _________________________________________________________________________
4. _________________________________________________________________________
5. _________________________________________________________________________
__________________________________________
Dept.
Chair Date
__________________________________________
Dean Date
Oct. 2000