Applicant Monitoring Form

INDIANA UNIVERSITY KOKOMO APPLICANT MONITORING FORM

Please complete this form, which Indiana University Kokomo sends routinely to job applicants. The results will be collected by our Office of Affirmative Action. Submission is voluntary. Whether or not you respond will not jeopardize your application.

The Office of Affirmative Action issues these forms solely in accordance with our Affirmative Action Program and applicable laws and regulations. Please direct any questions or comments to: IU Kokomo Office of Affirmative Action, 120 East Building, Kokomo, Indiana, 46902, phone (765) 455-9529.

1. Your Name: 
   Position you are applying for:
2. Sex:
3. Age:
4. Ethnic group: 
5. In accordance with federal law, IU employs only U.S. citizens and noncitizens authorized to work in this country. IU will assist individuals needing work authorization to obtain the visa status necessary to be employed here. Please indicate your present status:
6. Veteran Status:
7. How did you learn about the position?

Ethnic Group:

American Indian or Alaskan Native - A person having origins in any of the original peoples of North America, and who maintain cultural identity through tribal affiliations or community recognition.

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 Phillipine Islands, Thailand, and Vietnam.

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

Hispanic or Latino - A person of Mexican, Puerto Rican, Cuban, Central or South American, or other Spanish culture or origin, regardless of race.

Multiracial - Persons having a biological parent who is of a different race from the other biological parent [Indiana Code 5-15-5.1-6.5, effective July, 1995.]

Native Hawaiian or 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 origianl peoples of Europe, North Africa, or the Middle East.

Veteran Status:

Recently Separated Veteran - any veteran during the three-year period beginning on the date of such veteran's discharge or release from active duty in the U/S/ military, ground, naval, or air service.

Other Protected Veteran - a veteran who served on active duty in teh U.S. military ground, naval or air service during a war or in a campaign or expedition for which a campaign badge has been authorized, under laws administered by the Department of Defense.

Armed Forces Service Medal Veteran - any veteran who, while serving on active duty in the U.S. military ground, naval, or air service, participated in United States military operation for which Armed Forces service medal was awarded pursuant to Executive Order 12985.