- Staff Affirmative Action Compliance Form
Online Pdf form used for Hiring Officers. Please type, print, and sign the form. Attach this to your hiring paperwork and submit to your Compliance officer. Please download the
Affirmative Action Checklist for more information.
- Voluntary
Self ID Form
In accordance with federal law, we invite you to self-identify if you are a person with a disability or a covered veteran as defined on the attached form. Self-identification of a disability or veteran status is strictly voluntary . You may self-identify at any time during your employment with the University. To self-identify, please complete the form and return it to our office.Completed self-identification forms are maintained in files separate from that individual's personnel file and are held in strict confidence, except that:
- Administrators, managers, or supervisors may be informed of any work restrictions or reasonable accommodations;
- First aid or safety personnel may be informed, to the extent necessary, to administer any emergency treatment; and
- Government officials may review the forms in conjunction with an investigation or audit of the University's compliance with relevant federal, state or local law.
- Complaint of Discrimination,
Harrasment and/ or Retaliation Form
Online Pdf form used for filing complaints. Please type in all
information, print,sign and submit form to our office
- Request for Reasonable Accomodations
Form
Online Pdf form used to request reasonable workplace accomodations.Please
type in all information, print,sign and submit form to our office
- Penn Access Transit Form
Online Pdf form used for Penn Access Transit (HandyVan/ PAT) Registration
for Faculty and Staff. PAT service is transportation services available for faculty, staff and students with mobility and vision diabilities. You must have authorization from our office or Office of Student Disabilities Services (for students). Faculty and staff members must complete the form, print, sign
and submit it to our office along with medical documentation to register for this service.
- Race/Ethnicity Voluntary Form
The University of Pennsylvania is an equal opportunity employer with a policy of non-discrimination. As a federal contractor, Penn must comply with federal regulations pertaining to
affirmative action, equal opportunity, and non-discrimination. We ask your assistance in helping us to meet our federal compliance obligations of monitoring our hire, internal hire and transfer processes. The information you provide on this form will be maintained
confidentially.
- Request Form for lists of Faculty or Staff Information
In order for our office to complete your request for mailing labels of faculty and staff members, the University's Privacy policy now requires individuals to submit all requests on the Attachment A form (Request for Student, Staff or Faculty Data). Please complete the form and fax it to our office at 215-662-7862.
For further information see “Protecting Penn Data” at www.upenn.edu/privacy .
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