ࡱ> 02/ &bjbj 4"g I0$yfEDDDDDDD.D0IDDDD@DDI : Requisition Number_______________________ JOB SEEKER EEO SURVEY The ձһƬ is an Equal Opportunity/Affirmative Action employer. As a potential Federal government contractor, we are required to keep records and perform statistical analysis of our job seekers by race, ethnicity and gender. The information is treated confidentially and is never shared with those engaged in any employment decisions. Providing the requested information is strictly voluntary, but for any statistical analysis to be accurate and meaningful, we must collect information on as many job seekers as possible. Your cooperation in helping us meet our reporting requirements not only provides valuable data for analysis, but also enhances our ability to reach as many potential job seekers as possible through our outreach efforts. You are asked to submit the information requested in Section A. We hope that you will also provide the information requested in Section B. If you do not wish to provide the requested information solicited in Section B, please check the box indicating I decline to provide. NAME____________________________________________________________ZIP CODE___________ Please be specific in your responses: Section A 1. Position applying for; Job Title__________________________________________________________ 2. How did you learn of this vacancy? ______________________________________________________ Examples: m University of Scranton website; m Chronicle of Higher Education; m DiverseJobs.net m Newspaper/Journal Publication____________________ (Title); m Careerlink or other Government Job Service; m Conference/Job Fair___________________________ (Location); m Discipline specific media______________ (Title); m Other________________________ Section B The following designations are those currently required to be reported to the Federal government. Please mark only one sex and one race or ethnic group. 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