P & P No. 802.05

Page 4

 

 

Form C

Affirmative Action

Selection of Candidates for Interviews

 

 

 

Title of Position:                                                                                                                                                                                  

 

Department:                                                                                                                          Supervisor:_______________________

 

Date:____________________________________

 

1.0                 List all candidates to be interviewed.

 

 

 

Date

 

 

Race

 

 

 

Sex

 

 

No

Non-Citizen

Applicant Name

of  App.

Blk

As

AI

H

Mlti

W

M

F

Disabled

Vet

Info

Non-Perm. Resident

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2.0                 Totals:

Race:

Black

 

Asian

 

Am. Native/ Ind.

 

Hispanic

 

White

 

Multi

 

Sex:

Males

 

Females

 

 

 

 

 

 

 

 

 

Disabled

 

 

 

 

 

 

 

 

 

 

 

Veterans

 

 

 

 

 

 

 

 

 

 

 

No Information

 

 

 

 

 

 

 

 

 

 

 

US Citizens/Permanent Residents

 

  Non-Citizens/Non-Permanent Residents

 

 

 

               

AA Officer Comments:

 

 

 

                                                                                                                                                                                                                               

AA/EEO Officer                                                                                                                                                   Date