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Office of Human Resources

Applicant Data Form

Human Resources Employment Information Form

  Thank you for your interest in employment with Eastern University. Your cover letter and resume have been forwarded to the Hiring Manger/Search Committee for review and no further action is required regarding your candidacy.

In order to help us properly complete the recruitment process, please fill out the information requested and submit it to us as soon as possible.

Eastern University, a Christian university of the liberal arts and sciences, does not discriminate against individuals on the basis of race, color, gender, disability, age, genetic information, veteran status, or national/ethnic origin in its educational programs, university-administered programs, admissions and employment practices, policies, programs or activities. Women and minorities are encouraged to apply. The information below will be used by the University and government agencies for research and statistical purposes. Completion of this data is voluntary and will not affect your opportunity for employment or terms or conditions of employment, if hired.

Mr.   Ms.    Miss    Mrs.
 
 
 
 
First Name:  
Last Name:  
Search Number:  
Position Applied for:  


Ethnicity

Hispanic or Latino - A person of Cuban, Mexican, Puerto Rican, South orCentral American, or other Spanish culture or origin regardless of race.
Not Hispanic or Latino - A person that does not identify themselves within the Hispanic or Latino culture/origin.

Race
(Please choose one or more of the groups below with which you identify)

American Indian or Alaska Native - A person having origins in any of the original peoples of North and South America (including Central America), and who maintain tribal affiliation or community attachment.
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.
Black/African American - A person having origins in any of the black racial groups of Africa.
Native Hawaiian or other Pacific Islander - A person having origins in any of the peoples of Hawaii, Guam, Samoa, or other Pacific Islands.
White - A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.

Gender
   Female  Male
Disabled   Yes       No
Veteran
   Yes       No
Disabled Veteran
   Yes       No
VETERAN STATUS (Please check one if it describes your veteran status):
SPECIAL DISABLED VETERAN: Means (A) a veteran who is entitled to compensation (or who, but for the receipt of military retired pay, would be entitled to compensation) under laws administered by the Department of Veteran Affairs for a disability rated at 10 or 20 percent in the case of a veteran who has been determined to have a serious employment disability or (B) a person who was discharged or released from active duty because of a service-connected disability.
VIETNAM ERA VETERAN: A Vietnam Era veteran is a person who (1) served on active duty for a period of more than 180 days, any part of which occurred between August 5, 1964, and May 7, 1975, and was discharged or released with other than a dishonorable discharge; (2) was discharged or released from active duty for a service connected disability if any part of such active duty was performed between August 5, 1964, and May 7, 1975; or (3) served on active duty for more than 180 days and served in the Republic of Vietnam between February 28, 1961, and May 7, 1975.


How did you hear about this position ?

Chronicle of Higher Education
Professional Journal/Newsletter
Ethnic Media or Women's Media
College/University Placement Office
Eastern University Employment Opportunities website
Professional Society/Association
Referral Agency
Newspaper Advertisement
   Which paper?
Social Networking
Word of Mouth (Friend/Colleague)
Other
   Please explain