Affirmative Action Data Questionnaire
As an applicant for employment with the University of Wisconsin-Platteville, we ask that you complete the following Affirmative Action/Equal Employment Opportunity (“AA/EEO”) Data Questionnaire. As recipients of federal contracts, the University of Wisconsin-Platteville is required by law to request data from applicants for employment in order to monitor their recruitment and selection practices. Submission of the information requested on this web-based questionnaire is entirely voluntary. The information you provide will be used to meet the university’s data collection and reporting responsibilities, and to assess the effectiveness of our AA/EEO recruitment and selection efforts. The information will be kept confidential and will not be provided to the hiring authority or the search committee. Moreover, you will not be excluded from consideration if you decline to provide this information.

Please enter your applicant information. Press the “Submit” button to send the information.

Affirmative Action Data Questionnaire

Male      Female      Do not wish to respond

*Wisconsin Fair Employment Law defines an individual with a disability as one who a) has a physical or mental impairment which makes achievement unusually difficult or limits the capacity to work; b) has a record of such an impairment; or c) is perceived as having such an impairment.


Black, not of Hispanic origin
Asian or Pacific Islander
American Indian or Alaskan Native
White, not of Hispanic Origin
Do not wish to respond

Explanation of Race or Ethnicity Identification:

Black, not of Hispanic origin: A person having origins in any of the Black racial groups of Africa.

Asian or Pacific Islander: A person having origins in any of the original peoples of the Far East, Southeast Asia , the Indian Subcontinent, or the Pacific Islands. This area includes, for example, China, Japan, Korea, the Philippine Islands and Samoa.

American Indian or Alaskan Native: A person having origins in any of the original peoples of North America and who maintain cultural identification through tribal affiliation or community recognition.

Hispanic: A person of Cuban, Mexican, Puerto Rican, Central or South American or other Spanish culture or origin, or who identifies him/herself as Latina/o or Chicana/o, regardless of race.

White, not of Hispanic Origin: A person having origins in any of the original peoples of Europe, North Africa or the Middle East.

I agree to allow the Affirmative Action Office to release my name with the above information to the Search and Screen Committee, if it is requested and if I am among the final candidates.