EASTERN CONNECTICUT STATE UNIVERSITY
Office of Equity and Diversity
To the Applicant:
Thank you for your interest in Eastern Connecticut State University. We would appreciate your completing the
following information and returning it to the Office of Equity and Diversity at your earliest convenience to:
ZHUJ@EASTERNCT.EDU
Employment and participation in programs and activities at Eastern Connecticut State University are nondiscriminatory on the basis of sex, race, color, religion, age, national origin, handicapped status or veteran status.
The information you are asked to provide is the result of a federal requirement of the University under Executive
order 11246. THIS INFORMATION WILL BE MAINTAINED IN FILES IN THE OFFICE OF EQUITY
AND DIVERSITY.
Please Complete:
Name:
Position Applied for (Department Position):
Sex:
Race:
Male
Female
Native American
Asian/Pacific Islander
Black
Hispanic
White
Person with a disability:
Yes
No
How did you learn about this position?
Chronicle of Higher Education
Professional Journal/Newsletter
Ethnic Media or Women’s Media
College/University Placement Office
College/University Academic Department
Professional Society/Association
Referral Agency
Newspaper Advertisement. Which paper?
Word of Mouth (Friend/Colleague)
Internet
Other:
ECSU AAO-1 (Rev. 2/96)
Electronic Affirmative Action Card (Rev. 2/00)