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Hiring Monitor
Section I (to be completed by designated agency personnel)
Name of Agency: ________________________ IDHR Region: ___________________________ Facility/Unit: ________________________ Candidate’s Name ___________________________
Title of job to be filled: ________________________ Pay grade: ___________________________
Number to be filled: ________________________ Position Number ___________________________
EEO job category: ________________________ Employment date: ___________________________
1 Is this EEO category underutilized? Yes _____ No _____
If yes, by African Americans____ Hispanics____ Women____ Asians____ Native Americans____
Disabled____
2 Indicate: Sex of person(s) selected: _______________________________ Race of person(s) selected: _________________________
Veteran or non-veteran: _______________________________
Disability, if any: _______________________________
3 Number of individuals who applied or were on the list of eligible(s): _______________
_____were African American, _____invited, _____interviewed, _____selected
_____were Hispanic, _____invited, _____interviewed, _____selected
_____were Women, _____invited, _____interviewed, _____selected
_____were Asian, _____invited, _____interviewed, _____selected
_____were Native American, _____invited, _____interviewed, _____selected
_____were Veterans, _____invited, _____interviewed, _____selected
_____were Disabled, _____invited, _____interviewed, _____selected
_____were Undefined, _____invited, _____interviewed, _____selected
4 If no candidates from any of the underutilized groups appeared on the list, what efforts were made to assist in the recruitment of candidates?
5 If the category is underutilized and a member of an affirmative action group applied and was not hired, give a detailed explanation for the hiring decision?
6 Was the position posted? Yes_____ No_____
7 Name and position of person(s) who interviewed candidates.
8 Name and position of person(s) ultimately responsible for the selection.
Section II (To be signed by agency EEO/AA Officer and Chief Executive Officer or their designees)
I have reviewed the eligibility list and concur / do not concur with this hire. Remarks on reverse side.
________________________________________________ ______________________
EEO/AA Officer Date
I approve of this hire.
________________________________________________ ______________________
Chief Executive Officer Date
No appointment will be processed without this form. [DHR Rules and Regulations Section 2520.770(h)]
DHR-19 (Rev 11-06)
