Equal Employment Opportunity Form

ISU is an Equal Opportunity/Affirmative Action employer and complies with all applicable federal and state regulations. The Federal Government requires some employers who receive federal funding to collect and report statistical information on all employees. The data requested below is used to meet federal and state "Equal Employment Opportunity" requirements and will be used in accordance with federal rules and regulations.

Name (Last Name, First Name) *

Race and Ethnic Status

Are you of Latino or Hispanic origin? (A person of Mexican, Puerto Rican, Cuban, Central or South American, or other Spanish Culture or origin, regardless of race)

Latino Or Hispanic *

Yes

If No. Please choose one or more of the following designations:

Other Ethnicities

American Indian or Alaskan Native – A person having origins in any of the original peoples of North America and who maintain cultural identification through tribal affiliation or community recognition.

Black or African-American – A person having origins in any of the Black racial groups of Africa.

White, not of hispanic Origin - A person having origins in any of the original people of Europe, North Africa, or the Middle East

Asian - A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian Subcontinent, including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.

Native Hawaiian or Other Pacific Islander - A person having origins in any of the original peoples of the Hawaii, Guam, Samoa, or other Pacific Islands.

Gender

Gender *

Male

Female

(Check one)

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