Diversity and Equity - Affirmative Action Response

To The Applicant:

Thank you for your interest in employment with Southern Connecticut State University. We would appreciate your completing the following information and returning it to the Office of Diversity and Equity Programs.

Employment and participation in programs and activities at Southern Connecticut State University are non-discriminatory on the basis of sex, race, color, religion, age, national origin, disability status or veteran status. The information you are asked to provide is a result of Connecticut State Statutes in accordance with requirements under CGS46a-68.

This information will be maintained in files in the office of Diversity and Equity Programs.

Position Applied for*

Search Number*

If not preceded by a letter enter zeros before the search number. Ex: 0011-111

Department*

Specialization (Faculty Only)

Last Name*

First Name*

Race*

Gender*

Disability status

Veteran Status

How did you learn about this position?*

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Other