Page 4
Form B
Affirmative Action
Profile of Applicants
Title of Position:
Department: Supervisor:
Date:
1.0 List all applicants for the position as follows:
Note: Statistical data to be shown
only for citizens of the
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Date |
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Race |
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Sex |
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No |
Non-Citizen |
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Applicant Name |
of App. |
Blk |
As |
AI |
H |
Mlti |
W |
M |
F |
Disabled |
Vet |
Info |
Non-Perm. Resident |
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2.0 Totals:
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Race: |
Black |
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Asian |
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Am. Native/Ind. |
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Hispanic |
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White |
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Multi |
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Sex: |
Males |
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Females |
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Disabled |
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Veterans |
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No Information |
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US Citizens/Permanent Residents |
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Non-Citizens/Non-Permanent Residents |
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AA Officer Comments:
AA/EEO Officer Date