EEO Supplemental Application Information Form

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GRAMBLING STATE UNIVERSITY Human Resources/EEO SUPPLEMENTAL APPLICANT INFORMATION FORM (VOLUNTARY INFORMATION) EEO FORM #SA102

  <div style="text-align: center;"><strong>IF YOU ARE APPLYING FOR A POSITION AT GRAMBLING STATE UNIVERSITY, PLEASE COMPLETE THIS FORM.</strong></div> Grambling State University is required by Federal Law to report specific information regarding our applicant pool. The information will be used exclusively for internal and external monitoring and reporting. Complete and return this form via email to: <a href="mailto:Bradleym@gram.edu">Bradleym@gram.edu</a> or regular mail to: Grambling State University, Human Resources/EEO Office, GSU Box 4261, Grambling, LA 71245 Name: This field is required. Address: This field is required. Email Address: This field is required. Position Applying for: Ethnic Origin: Black White Hispanic American Indian or Alaskan Native Asian/Pacific Islander Ethnic Origin Other: Gender: This field is required. Male Female Disability: This field is required. Yes No Veteran Status: This field is required. Veteran before 8/64 Vietnam Era Veteran Veteran Disabled Not a Veteran

Your form has been submitted! Thank you for your interest in employment at Grambling State University. If you have any questions or need further assistance, please contact us at:&nbsp;(318) 274-2237 or <a href="mailto:Bradleym@gram.edu">bradleym@gram.edu</a>. Your form was not submitted. If you have any questions or need further assistance, please contact us at:&nbsp;(318) 274-2237 or <a href="mailto:Bradleym@gram.edu">bradleym@gram.edu</a>. empapp@gram.edu; bradleym@gram.edu formdefault@gram.edu Supplemental Application Information Form