{"id":665,"date":"2019-02-11T17:02:15","date_gmt":"2019-02-11T17:02:15","guid":{"rendered":"http:\/\/wcsu.wpengine.com\/diversity\/?page_id=665"},"modified":"2025-05-15T20:30:35","modified_gmt":"2025-05-15T20:30:35","slug":"affirmative-action-data-questionnaire","status":"publish","type":"page","link":"https:\/\/www.wcsu.edu\/diversity\/affirmative-action-data-questionnaire\/","title":{"rendered":"AFFIRMATIVE ACTION DATA QUESTIONNAIRE"},"content":{"rendered":"<div class=\"row\">\n<div class=\"col-md-4\"><img decoding=\"async\" class=\"aligncenter\" src=\"\/diversity\/wp-content\/uploads\/sites\/37\/2019\/02\/Primary.jpg\" width=\"213\" height=\"214\" \/><\/div>\n<div class=\"col-md-8\">\n<div style=\"padding: 10px; margin-top: 30px;\">\n<p style=\"text-align: center;\"><em>Office of Diversity &amp; Equity<\/em><\/p>\n<p>In an effort to comply with State and Federal requirements, we are requesting that you take a moment to complete this questionnaire. Disclosure of the information is voluntary and will not affect your opportunity for employment, or terms or conditions of employment. The information provided will be used for State and Federal required workforce reporting purposes only and maintained in a confidential manner separate from your application.<\/p>\n<\/div>\n<\/div>\n<\/div>\n<style>.wForm form{text-align: left;}<\/style><!-- FORM: HEAD SECTION -->\n    <meta http-equiv=\"Content-Type\" content=\"text\/html; charset=utf-8\" \/>\n    <meta name=\"referrer\" content=\"no-referrer-when-downgrade\">\n    <!-- THIS SCRIPT NEEDS TO BE LOADED FIRST BEFORE wforms.js -->\n    <script type=\"text\/javascript\" data-for=\"FA__DOMContentLoadedEventDispatch\" src=\"https:\/\/westconn.tfaforms.net\/js\/FA__DOMContentLoadedEventDispatcher.js\" defer><\/script>\n        <script type=\"text\/javascript\">\n        document.addEventListener(\"FA__DOMContentLoaded\", function(){\n            const FORM_TIME_START = Math.floor((new Date).getTime()\/1000);\n            let formElement = document.getElementById(\"tfa_0\");\n            if (null === formElement) {\n           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href=\"https:\/\/westconn.tfaforms.net\/dist\/form-builder\/5.0.0\/wforms-jsonly.css?v=84c9e9ebc8ad47335cb5121d6c8e6fb90e8a3a52\" rel=\"alternate stylesheet\" title=\"This stylesheet activated by javascript\" type=\"text\/css\" \/>\n    <script type=\"text\/javascript\" src=\"https:\/\/westconn.tfaforms.net\/wForms\/3.11\/js\/wforms.js?v=84c9e9ebc8ad47335cb5121d6c8e6fb90e8a3a52\"><\/script>\n    <script type=\"text\/javascript\">\n        if(wFORMS.behaviors.prefill) wFORMS.behaviors.prefill.skip = true;\n    <\/script>\n    <script type=\"text\/javascript\" src=\"https:\/\/westconn.tfaforms.net\/wForms\/3.11\/js\/localization-en_US.js?v=84c9e9ebc8ad47335cb5121d6c8e6fb90e8a3a52\"><\/script>\n\n<!-- FORM: BODY SECTION -->\n<div class=\"wFormContainer\" >\n    <div class=\"wFormHeader\"><\/div>\n    <style type=\"text\/css\">\n                #tfa_1,\n                *[id^=\"tfa_1[\"] {\n                    width: 385px !important;\n                }\n                #tfa_1-D,\n          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The area includes, for example, China, Japan, Korea, the Philippine Islands, and Samoa.<\/label><\/span><span class=\"oneChoice\"><input type=\"radio\" value=\"tfa_18\" class=\"\" id=\"tfa_18\" name=\"tfa_8\" aria-labelledby=\"tfa_18-L\" data-tfa-labelledby=\"tfa_8-L tfa_18-L\" data-tfa-parent-id=\"tfa_8\"><label class=\"label postField\" id=\"tfa_18-L\" for=\"tfa_18\"><span class=\"input-radio-faux\"><\/span>Two or more race categories - all persons who identify with more than one of the above.<\/label><\/span><\/span><\/div>\n<\/div>\n<div class=\"oneField field-container-D  labelsLeftAligned  \" id=\"tfa_19-D\">\n<label id=\"tfa_19-L\" class=\"label preField \" for=\"tfa_19\">Position for which you are applying:<\/label><div class=\"inputWrapper\"><input type=\"text\" id=\"tfa_19\" name=\"tfa_19\" value=\"\" title=\"Position for which you are applying:\" class=\"\"><\/div>\n<\/div>\n<div class=\"oneField field-container-D  labelsLeftAligned  \" id=\"tfa_21-D\">\n<label id=\"tfa_21-L\" class=\"label preField \" for=\"tfa_21\">Search #:<\/label><div class=\"inputWrapper\"><input type=\"text\" id=\"tfa_21\" name=\"tfa_21\" value=\"\" title=\"Search #:\" class=\"\"><\/div>\n<\/div>\n<fieldset id=\"tfa_22\" class=\"section\">\n<legend id=\"tfa_22-L\">How were you referred to us?<\/legend>\n<div class=\"oneField field-container-D    \" id=\"tfa_23-D\">\n<label id=\"tfa_23-L\" class=\"label preField \" for=\"tfa_23\"><span style=\"font-size: 14.4px;\">Newspaper or journal advertisement&nbsp;<\/span><span style=\"font-size: 14.4px;\">Specify which one(s)<\/span><\/label><br><div class=\"inputWrapper\"><textarea id=\"tfa_23\" name=\"tfa_23\" title=\"Newspaper or journal advertisement Specify which one(s)\" class=\"\"><\/textarea><\/div>\n<\/div>\n<div class=\"oneField field-container-D    \" id=\"tfa_25-D\">\n<label id=\"tfa_25-L\" class=\"label preField \" for=\"tfa_25\"><span style=\"font-size: 14.4px;\">Professional Associations&nbsp;<\/span><span style=\"font-size: 14.4px;\">Specify which one(s)<\/span><\/label><br><div class=\"inputWrapper\"><textarea id=\"tfa_25\" name=\"tfa_25\" title=\"Professional Associations Specify which one(s)\" class=\"\"><\/textarea><\/div>\n<\/div>\n<div class=\"oneField field-container-D  labelsLeftAligned  \" id=\"tfa_26-D\">\n<label id=\"tfa_26-L\" class=\"label preField \" for=\"tfa_26\">Employee Referral<\/label><div class=\"inputWrapper\"><input type=\"text\" id=\"tfa_26\" name=\"tfa_26\" value=\"\" title=\"Employee Referral\" class=\"\"><\/div>\n<\/div>\n<div class=\"oneField field-container-D  labelsLeftAligned  \" id=\"tfa_28-D\">\n<label id=\"tfa_28-L\" class=\"label preField \" for=\"tfa_28\">Internet Posting (please specify?<\/label><div class=\"inputWrapper\"><input type=\"text\" id=\"tfa_28\" name=\"tfa_28\" value=\"\" title=\"Internet Posting (please specify?\" class=\"\"><\/div>\n<\/div>\n<\/fieldset>\n<div class=\"actions\" id=\"158-A\" data-contentid=\"submit_button\"><input type=\"submit\" data-label=\"Submit\" class=\"primaryAction\" id=\"submit_button\" value=\"Submit\"><\/div>\n<div style=\"clear:both\"><\/div>\n<input type=\"hidden\" value=\"668-fac0c2dd8b48f05b8d6ba224153dc597\" name=\"tfa_dbCounters\" id=\"tfa_dbCounters\" autocomplete=\"off\"><input type=\"hidden\" value=\"158\" name=\"tfa_dbFormId\" id=\"tfa_dbFormId\"><input type=\"hidden\" value=\"\" name=\"tfa_dbResponseId\" id=\"tfa_dbResponseId\"><input type=\"hidden\" value=\"bc2fa187644d1671d8262124eb0c3671\" name=\"tfa_dbControl\" id=\"tfa_dbControl\"><input type=\"hidden\" value=\"\" name=\"tfa_dbWorkflowSessionUuid\" id=\"tfa_dbWorkflowSessionUuid\"><input type=\"hidden\" value=\"1776703500\" name=\"tfa_dbTimeStarted\" id=\"tfa_dbTimeStarted\" autocomplete=\"off\"><input type=\"hidden\" value=\"5\" name=\"tfa_dbVersionId\" id=\"tfa_dbVersionId\"><input type=\"hidden\" value=\"\" name=\"tfa_switchedoff\" id=\"tfa_switchedoff\">\n<\/form>\n<\/div><\/div><div class=\"wFormFooter\"><p class=\"supportInfo\"><br><\/p><\/div>\n  <p class=\"supportInfo\" >\n      <\/p>\n <\/div>\n\n<script\n    id=\"analytics-collector-script\"\n    type=\"text\/javascript\"\n    src=\"https:\/\/westconn.tfaforms.net\/dist\/analytics\/data-collector.f9f54c12ade21135b7c2.js\"\n    data-customer-id=\"766\"\n    data-endpoint=\"https:\/\/analytics.formassembly.com\/v1\/traces\"\n><\/script>\n\n\n<p style=\"text-align: center; margin-top: -80px;\"><em>The security of all members of the campus community is of vital concern to Western Connecticut State University. In compliance with the Jeanne Clery Disclosure of Campus Security Policy and Crime Statistics Act, information concerning campus security can be found online at\u00a0<a href=\"https:\/\/www.wcsu.edu\/police\/\">https:\/\/www.wcsu.edu\/police\/<\/a>\u00a0or\u00a0may be requested from the Western Connecticut\u00a0State\u00a0University\u2019s Police Department (203-838-9304)<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Office of Diversity &amp; Equity In an effort to comply with State and Federal requirements, we are requesting that you take a moment to complete this questionnaire. Disclosure of the information is voluntary and will not affect your opportunity for &hellip;<\/p>\n","protected":false},"author":131,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"left-navigation.php","meta":{"footnotes":""},"class_list":["post-665","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/www.wcsu.edu\/diversity\/wp-json\/wp\/v2\/pages\/665","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.wcsu.edu\/diversity\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.wcsu.edu\/diversity\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.wcsu.edu\/diversity\/wp-json\/wp\/v2\/users\/131"}],"replies":[{"embeddable":true,"href":"https:\/\/www.wcsu.edu\/diversity\/wp-json\/wp\/v2\/comments?post=665"}],"version-history":[{"count":0,"href":"https:\/\/www.wcsu.edu\/diversity\/wp-json\/wp\/v2\/pages\/665\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.wcsu.edu\/diversity\/wp-json\/wp\/v2\/media?parent=665"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}