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    Affirmative Action Recruitment Report Form

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    Please note: This sample Affirmative Action Recruitment Report is provided for you by HR.com as a free service. The free hr templates and forms on this site are general in nature and not based on the laws of any specific state or other jurisdiction. Prior to using these policies or forms, we recommend that you consult with an attorney or other expert knowledgeable in the laws of the applicable jurisdiction and the specific intended use of those documents.

    Affirmative Action Recruitment Report

     

    Once a final candidate has been selected, complete the following form and attach it to the recruitment file.  The file should then be forwarded for the appropriate signatures prior to a job offer being extended.

     

    Group Identification Codes:

    A  - Asian

    AI - American Indian

    B  - Black

    D  - Disable

    H  - Hispanic

    W - Woman

     

    Selected Candidate:

     

    ________________________________________________________________________________

    Last Name, First Name

     

    ___________________________                                                        

    Position Number                  

                                                                                   

    ___________________________

    Control Number   

     

    ___________________________

    Requisition Number

     

    _________________________________________________________________________________                                                                        
    Department

     

    ___________________________

    Proposed Salary

     

    ___________________________

    Proposed Start Date

                                                                                                   

     

    Provide a description of the applicant pool below.  Provide job related reason as to why the candidate was not selected must be provided.

     

    Applicant Name

    Sex

    Race

    Reason For Not Selecting

    Screened By

    Initials

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

    Signatures:

     

     

    _________________________________________________________________________________                 

    Affirmative Action Coordinator                                          

     

    _______________________________

    Date

     

    __________________________________________________________________________________

    Director, Human Resources

     

    _______________________________

    Date    

     


                                                                                                                       



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