**************************************************************** AFFIRMATIVE ACTION INFORMATION FORM (PER 18-1) This information is requested to determine LSU's compliance with civil rights laws, and your response will not affect consideration of your application. By providing this information, you will assist us in assu= ring that this program is administered in a nondiscriminatory manner. Part I. Please indicate the following information by typing in your response. The department should fill in position title/number, department and anticipated hire date. ? Applicant's Name: Anatoly Miroshnichenko ? Position Title/Number: Assistant Professor/Log#0364 ? Department: Physics and Astronomy ? Anticipated Hire Date: Fall 2003 Part II. The following information is optional. If you do wish to disclose, please indicate the selection to each question that applies to you by underlining it or typing an "X" in the space to the left of it. If you do not wish to disclose this information, please go to Part III. 1. What is your racial or ethnic heritage? American Indian or Alaskan Native Black (not of Hispanic origin) Hispanic X White (not of Hispanic origin) Asian or Pacific Islander 2. What is your sex? X Male Female 3. How/Where did you find out about this position (If website, please indicate site address). Part III. Please respond to this statement if you do not wish to disclose any of the above information for Part II. To respond, please underline the yes or type an "x" in the space to the left of it. Also, type in today's date. I do not wish to indicate any of the information for Part II. Yes Date: If you are unable to return by email please fax it to (225)578-6571.