Equal Employment Opportunity Information Request Form

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The information on this form is used for Institutional Research only. Thank you for your input.
Position Applied for: 
Gender: Female Male
Age:
Referral Source: How did you learn about this position at DePauw?

DePauw Employee
Private Personnel Agency
Walk-in
Classified Ad 
      Please specify publication:
Other
      Please specify:

Ethnic Background: Check race-ethnic category(ies) with which you most clearly identify.

Ethnicity:

Not Hispanic or Latino
Hispanic or Latino

Race:

American Indian / Alaskan Native
Asian
Black or African American
Native Hawaiian / Other Pacific Islander
White

    
 

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email: susanhacker@depauw.edu

 Last Updated: April 28, 2004