Voluntary Affirmative Action Information

This information is voluntary and confidential.  Texas Christian University uses this information to compile statistics required for equal opportunity and affirmative action compliance.

Position applied for

Name

Date

Sex

Race

Veteran Status

_____male

_____female

_____White

_____Black

_____Hispanic origin

_____Asian – Pacific Islander – Indian Subcontinent

_____American Indian – Alaskan Native

_____Vietnam-era veteran (8/5/64-5/7/75)

_____Special disabled veteran (Veteran’s

          Aministration-rated disability 30% or more)

Disabled

Yes____ No____