Welcome to Arkansas State University!

Voluntary Demographic Disclosure Form

This form is available for individuals applying for a university position not advertised through the AstateJobs website, such as positions utilizing a recruiting firm. Reported demographic information is not utilized for individual identification, but rather to insure diverse recruitment and retention of university employees by percentage in relation to the population of our student body and surrounding community.

(*) denotes required information.

* Applicant Name:
Position Applied For:
Position Number: (Note: This number is provided on the job posting.)
Gender: Male Female I choose not to disclose
Ethnicity: If you are Hispanic or Latino, please check this box: Hispanic or Latino

Race: If you did not select the Hispanic/Latino box, please check one of the Race categories:
White (not Hispanic or Latino)
Black or African American (not Hispanic or Latino)
Native Hawaiian or Other Pacific Islander (not Hispanic or Latino)
Hispanic or Latino
Asian (not Hispanic or Latino)
American Indian or Alaska Native (not Hispanic or Latino)
Two or more races (not Hispanic or Latino)
Choose Not to Disclose

Any questions regarding A-State's Equal Opportunity/Affirmative Action Policy should be addressed to the Office of Affirmative Action at (870) 972-2015.

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