Affirmative Action Report Form for Faculty
This is a two-page form. The first page is the Applicant Flow Data Entry form. The second page provides the additional documentation needed for the record. Part-time appointments only require page 1 to be completed. Following is a list of the data elements required to be completed:
Page One
1) Applicant Flow Indentification Number
Copy the number assigned to the Search Proposal form that authorized recruitment for the position to which the candidate is being recommended. It is in the upper right corner of the approved form that was returned to the School/College.
a) Generally, there should be a separate Search Proposal for each position. However, in the event that more than one appointment is recommended as a result of the same Search, where the same pool of applicants is used, indicate by inserting the sequential number as the second digit of the last four digit number. For example: the first appointment would show the assigned Applicant Flow ID Number, 20-201-02-0005, the second would be -0205, the third -0305.
b) If the appointment is one for which there was no prior authorization for recruitment, (e.g. an emergency, sudden unanticipated need or other special and unusual circumstance, or one for which the affirmative search requirement has been waived), leave the number blank and provide an explanation in the Recruitment Section of the form or attach a memorandum.
2) Recommended Faculty Academic Rank
Enter the rank code shown on the Academic Appointment form.
3) Social Security Number of Candidate Recommended
Enter the number as shown on the Academic Appointment form.
4) Mail Code
Optional for Charles River Campus.
5) Position Title
Complete only if appointee is to hold an administrative title in addition to faculty academic rank.
6) Position Opened
Insert the date (year/month/day) that the search commenced.
7) Position Closed
Insert the date (year/month/day) a recommendation for appointment is made.
8) Representation Status
Enter NREP (non-represented).
9) Appointment Status
Enter "1" for regular full-time; "3" for regular part-time, as defined in the Personnel/Payroll Procedures Manual.
10) Effective Date
Enter the date shown on the Academic Appointment form.
11) Recruiting Sources
Self-explanatory; however, it should conform to the Search Proposal and documentation must be attached. Please ensure that the title and date appear on extracts of publications submitted. Notation and dates of all contacts must be included. This provides a verifiable record of the affirmative recruitment effort.
12) Category
This section contains the Applicant Summary statistics that will determine whether any class of protected persons (women, minority, handicapped or veteran) is adversely affected by the University's selection process.
There are four columns representing applicants and candidates who must be identified:
i. Number of Applicants Received
An applicant is anyone who has indicated an interest in this specific position by appearing in person or submitting a letter and/or curriculum vita. Enter the total number of male and the total number of female applicants. Sub-categorize the totals by racial/ethnic characteristic or by non-citizen status (See Affirmative Action Codes and Definitions). The aggregate of White, Black, Hispanic, Asian/Pacific Islander, American Indian, and Non-citizen must equal the totals shown. Further identify U.S. citizens by veteran and/or handicapped status, if appropriate. To conform to recent Federal interpretation, you are asked to further identify the non-citizen cohort by indicating, in parenthesis, the appropriate race/ethnic categories [as defined in race code list] for each sex; the parenthetical insertions should be equal to the number of non-citizens.Please Note: It is recognized that it is not always possible to determine from a curriculum vita the racial/ethnic origin or sometimes the sex of an applicant. The requirements are that we track discernible minorities and women. If, using your best judgment, you cannot discern that an individual is a minority or non-citizen, classify as white, male, or female as appropriate. If you cannot discern that an individual is female, classify as male. You may, if you wish, asterisk as appropriate and indicate the number that represent "unknowns." However, this isn't required as long as you have made a "good faith" effort and full documentation is maintained.
When military service is evident, but qualification under the definition is uncertain, identify as veteran; annotate the application so that it is easily retrievable if required.
ii. Number of Candidates Interviewed
Enter the total number of men and the total number of women interviewed for the position. Sub-categorize each as described in section 12.i.iii. Number of Candidates to Whom Offer Extended
Enter the total number of men and the total number of women who were offered the position. Sub-categorize each as described in section 12.i.iv. Candidate(s) Who Accepted Offer
Enter the sex and applicable sub-category(ies), as indicated in section 12.i, of the candidate who is being recommended for appointment, (i.e., the person who has accepted a tentative offer, contingent upon its approval by the Administration and Trustees, as appropriate).If more than one person is appointed to the position, enter totals by sex and applicable sub categories, as described in section 12.i, and attach a list identifying each appointee by name, social security number, sex, and race/ethnic code.
13) Prepared By
Enter the name of the person who should be contacted if there are any questions concerning any of the entries.
Page Two
This page is not used for data entry on the automated Applicant Flow system, but is retained in affirmative action files as documentation in compliance with requirements for federal contractors.
14) Name
Enter name of the candidate recommended as it appears on the Academic Appointment form.
15) Applicant Flow Indentification Number
See section 1. Enter the same number.
16) School-Department
List unit and department name, as shown on the Academic Appointment form.
17) Position Description
Insert a brief description of position and qualifications required, if different from what was included on the Search Proposal form.
18) Membership of Interview Team
Enter if different from Search Committee identified on Search Proposal.
19) Minority and Female Candidates Interviewed and Not Offered the Position
Enter the name of minority and/or female candidates identified in section 12.ii, who were not offered the position and the reason for non-selection; be specific. Attach curriculum vita(e).
20) Minority and Female Candidates Extended an Offer which They Refused
Enter the name of any minority and/or female candidates from 12.iii, who refused an extended offer and the reason given; be specific.
21) Signatures
The form must be signed by both the department head and Dean. Enter date of signature.
Affirmative Action Codes and Definitions
| EEOC Group Code Primary Designation (1) |
Definition |
|---|---|
| AA | 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, American Samoa and Viet Nam. The Indian subcontinent takes in the countries of India, Pakistan, Bangladesh, Sri Lanka, Nepal, and Bhutan. |
| AI | American Indian or Alaskan Native A person having origins in any of the original peoples of North America or who maintains cultural identification through tribal affiliation or community recognition. |
| B | Black (not of Hispanic Origin) A person having origins in any of the Black racial groups of Africa. |
| 0 | Non-Citizen/Foreign National (2) A citizen or subject of a country other than the United States of America |
| SSA or HIS | Hispanic A person of Mexican, Puerto Rican, Cuban, Central or South American or other Spanish culture or origin, regardless of race. |
| W | White (not of Hispanic Origin) A person having origins in any of the original peoples of Europe, North Africa, or the Middle East. |
| Supplemental Designations (3) | |
| Veteran | A person covered by Section 4212 of the Vietnam Era Veterans Readjustment Assistance Act of 1974, as amended, which requires affirmative action with respect to qualified disabled veterans and veterans of the Vietnam era (February 28, 1961 - May 7, 1975) |
| Handicapped | A person covered by the Americans With Disabilities Act of 1990 and the Rehabilitation Act of 1974, as amended. The definition applies to a person who has a physical or mental impairment which substantially limits one or more of such person's major life activities, has a record of such impairment, or is regarded as having such impairment. |
- Primary designations are required for and are taken from the instructions for the Integrated Postsecondary Education Data System Survey (IPEDS-S) which is required by law to be filed with the federal government. The race/ethnic categories do not denote scientific definitions of anthropological origins. For reporting purposes, a person may be included in the group to which he or she appears to belong, identifies with, or is regarded in the community as belonging.
- While Non Citizen/Foreign National is a primary designation on the Affirmative Action Form, due to changing Federal interpretations, information also is being gathered (by parenthetical notation) for racial/ethnic identification of this cohort.
- Supplemental designations are required for affirmative action records in accordance with the statutes cited.
Please Note: Follow the above link to the online version of the form. Click on the save icon on the toolbar to download the form to your computer. Use Adobe Acrobat to open, complete, and save the form so you can go back to it. Print the completed form and obtain appropriate signatures on the printed copy. Forward the signed copy of the form, with relevant supporting materials, to the Affirmative Action Officer in the Office of the Provost.