As part of Frostburg State University’s policy on nondiscrimination and its Equal Opportunity Program, all applicants for employment are requested to voluntarily complete and submit this form. The Director of EEO uses this form in an attempt to monitor and enhance equal employment opportunity practices. If you have not previously done so, please take a few moments to provide the information requested below. A downloadable version of the form is also available (Word format).

Required Fields are marked with a red asterisk (*).

Firstname *
Lastname *
Gender *	Male Female
Ethnicity * (select one)	Hispanic or Latino Not Hispanic or Latino
Race * (select one or more; press Ctrl and click to select multiple values)	American Indian/Alaska Native Asian or Pacific Islander Black or African American White Other (specify)
If other, please specify
Are you an American Citizen? *     Yes No
If No, please specific country of origin and status in US.
Do you have any disability for which the University might make accommodations to enable you to perform in the position being applied for?  *   Yes No
If Yes, please indicate accommodations needed.
Are you a veteran of the Vietnam era? *    Yes No
Are you a disabled veteran? *    Yes No