EEOC Information Form


Cowley College Equal Employment Opportunity Commission Information Form Cowley County Community College is an Equal Opportunity employer and considers job applicants for all positions without regard to ethnicity, gender, veteran status, and disability in accordance with appropriate federal guidelines. SUBMITTAL OF THIS INFORMATION IS COMPLETELY VOLUNTARY AND WILL BE HELD STRICTLY CONFIDENTIAL. THE DATA PROVIDED HERE IS NOT A PART OF THE OFFICIAL APPLICATION FOR YOUR APPLICATION FOR EMPLOYMENT AND WILL BE PERMANENTLY SEPARATED FROM THE REST OF THE YOUR APPLICATION MATERIALS. In an effort to comply with the requirements regarding government record keeping, reporting, and other legal obligations, we ask that you complete the information below and return it directly to the Human Resource Director. We appreciate your cooperation.
Position Applying For:

Check One:	Male Female

Check one of the following Race/Ethnic Groups:
	American Indian/Alaskan Native African-American (Black) Asian/Pacific Islander Caucasian (White) Hispanic

Check if any of the following are applicable:
	Disabled Individual Disabled Veteran Vietnam Era Veteran

Referral Source (please identify source):
	Advertisement Employee Relative Walk-in Government Employment Agency Private Employment Agency Other:

Name of source (if applicable):

Date completed:


Please click the submit button only once. It may take a few minutes for a confirmation message to appear.