Personal EEO Data Form

The University of the Pacific is an Equal Opportunity Employer. Pacific is subject to certain governmental recordkeeping and reporting requirements for the administration of civil rights laws and regulations. In order to comply with these laws, Pacific invites employees to voluntarily self-identify their race or ethnicity. Submission of this information is voluntary and refusal to provide it will not subject you to any adverse treatment. The information obtained will be kept confidential and may only be used in accordance with the provisions of applicable laws, executive orders, and regulations, including those that require the information to be summarized and reported to the federal government for civil rights enforcement. When reported, data will not identify any specific individual. Please submit this form for each position applying for.

Name:

Position Applying For:

School/Unit: 

Department:

Please select one of the following options:

Male

Female

Are you Hispanic or Latino?

Yes

No

Select one or more races from the list below:

American Indian or Alaska Native

Asian

Check all Asian groups that apply:
Chinese
Cambodian
Filipino
Hmong
Indian
Japanese
Korean
Laotian
Pakistani
Thai
Vietnamese  

Black or African American

Native Hawaiian or Other Pacific Islander

Check all Native Hawaiian groups that apply:
Native Hawaiian
Samoan
Guamanian

White

If you are having trouble submitting this form, please copy the form into an email, provide your information and send to  ap_diversity@pacific.edu.