Office of Equal Opportunity & Affirmative Action
Revised on 1/26/2010
SEARCH COMMITTEE IDENTIFICATION FORM
Position Number: ____________________________ Title: ________________________________
In order for the EO/AA Office to identify the diversity of the Search Committee, please have each
member self identify themselves as requested below. Upon completion, please return to the EO/AA
Office Box immediately.
Race/Ethnicity:
1.
Hispanic or Latino (Of any Race/s)
2.
White - (Not Hispanic or Latino)
3.
Black or African American – (Not Hispanic or Latino)
4.
Asian – (Not Hispanic or Latino)
5.
American Indian or Alaska Native – (Not Hispanic or Latino)
6.
Native Hawaiian or Other Pacific Islander – (Not Hispanic or Latino)
7.
Two or more Races - (Not Hispanic or Latino)
Committee Member’s Name
Committee Title
Title
Search Chair
Member
Member
Member
Member
Member
Member
Prairie View A&M University
Office of Equal Opportunity & Affirmative Action
P. O. Box 519: MS 1107, Alvin I. Thomas Bldg., Suite 013
Prairie View, TX 77446
Email: EEOTeam@pvamu.edu
Race Sex