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Equal Opportunity Office

Faculty Applicant Information Form

Please provide us with the information requested below. Participation is voluntary, but will help us meet federal compliance obligations. Information will be sent to and used only by our Equal Opportunity Office.

All information volunteered is transferred on a secured server for confidentiality.

Applicant's Name:
Title of Position Applied for:
Department of Position Applied for:
Position Number:

Sex: Male Female
Race/Ethnicity: (check all that apply) Race/Ethnicity Definitions

American Indian/Alaska Native
Asian/Pacific Islander
Black/African-American
Hispanic or Latino descent
White/Caucasian

Referral Source:

Personal contact
Professional Journal
KUMC Employment Board Online Vacancy Listing, Job Line
Chronicle of Higher Education
Newspaper
Other (Specify)