Colorado School of Mines

Equal Employment Opportunity (EEO) Gender & Ethnicity

Voluntary Self Disclosure Form


Colorado School of Mines is an equal employment opportunity employer.  In order to comply with EEOC, OFCCP and Affirmative Action regulations, the School is required to compile summary data on the gender and ethnicity of its applicants and incumbent employees. 

The information solicited is collected for the sole purpose of providing data to be used for statistical analysis by the Office of Human Resources, maintained in separate files and is not used in the determination of your eligibility for promotion, transfer or tenure.  Providing this information is voluntary, however; the EEOC strongly endorses self-identification of race and ethnic categories, as opposed to visual identification by employers.

Enter your search information in the space provided below: 

                                 
Search Number ID*                   Position Applied For                        Department

* Search Number ID is located in the bottom right-hand corner of your acknowledgement letter.

Please identify your Gender:

  Male Female

Ethnic Origin:

(B) Black or African American (Not Hispanic or Latino)
(C) White (Not Hispanic or Latino)
(H) Hispanic or Latino
(I) American Indian or Alaska Native (Not Hispanic or Latino)
(N) I do not wish to provide this information
(O) Asian (Not Hispanic or Latino)
(P) Native Hawaiian or Other Pacific Islander
(X) Two or More Races (Not Hispanic or Latino)

How were you referred to this position?

CSM Website Annoucement
Invited to Apply
Friend/Associate
Newspaper/Journal
Professional Association Website/Listserv
Other

Thank you for completing this information.  After submitting the form, if you wish to returned to the Mines homepage, please click here


Copyright © 2007 [Colorado School of Mines]. All rights reserved.
Revised: 11/12/07