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

IF YOU ARE APPLYING FOR A POSITION AT GRAMBLING STATE UNIVERSITY, PLEASE COMPLETE THIS FORM.

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: Bradleym@gram.edu or regular mail to: Grambling State University, Human Resources/EEO Office, GSU Box 4261, Grambling, LA 71245

  Name Address Email Address Position Applying for Ethnic Origin African American Caucasian Hispanic Native American Asian/Pacific Islander Other Ethnic Origin Other Gender Male Female Disability Yes No Veteran Status VETERAN BEFORE 8/64 VIETNAM ERA VETERAN VETERAN DISABLED NOT A VETERAN

Your information has been submitted! Thank you Please click here to return to the position announcements. Your information has NOT been submitted! Please contact us for assistance and/or comments/suggestions. empapp@gram.edu form-default@gram.edu Supplemental Applicant Information Form