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Institutional Equity and Diversity

Affirmative Action Interview Authorization Form

Affirmative Action Interview Authorization Form

Section I: To be completed by Department or Hiring Unit

Department/Hiring Unit:
Date: (mm/dd/yyyy)
Position Title: (including Area of Specialty)
# of Applications received:
# of Contacts at Conferences/Meetings:
Estimated # Candidates: Females
Males
Minorities
Name Present Position Highest Degree & Granting Institution Sex/Race
Name of Search Committee Chair
Email Address

Section II: To be completed by Director of Affirmative Action and Diversity Programs

Department/Hiring Unit:
Date: (mm/dd/yyyy)
Position Title: (including Area of Specialty)
# of Applications received:
# Affirmative Action Surveys received:
American Indian or Alaskan Asian or Pacific Islander Black, Non-Hispanic Other Hispanic Vietnam Era Veteran White, Non-Hispanic
Female
Male
Recommendation to Provost/Director of Human Resources:

Choose e-mail recipient:

Cc to Dept Chair's email address:

Section III: To be completed by Provost/Director of Human Resources

Department/Hiring Unit:
Date: (mm/dd/yyyy)
Position Title: (including Area of Specialty)
Authorization to bring Candidates to Campus

Cc to Dept Chair's email address:
Authorization Denied