Voluntary Self-Identification
Our organization is subject to certain governmental recordkeeping and reporting requirements for administration of civil rights laws and regulations. In order to comply with these laws, we invite you to voluntarily self-identify your race, ethnicity, and gender. Submission of this information is voluntary and refusal to provide it will not subject you to any adverse treatment. All information will kept strictly confidential and will only be used in accordance with provisions of applicable laws, orders and regulations.
A. Gender (Sex) Information:
B. Ethnicity:
Hispanic or Latino: A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin regardless of race.
(Note: If Hispanic or Latino is selected, you do not need to select another group below.)
C. Individual Race:
American Indian or Alaska Native (not Hispanic or Latino): A person having origins in any of the original peoples of North American and South American (including Central American), and who maintains tribal affillation or community attachment.
Asian (not Hispanic or Latino): A person having origins in any of the original peoples of the Far
East, Southeast Asia, or the Indian subcontinent, including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan,
the Philippine Islands, Thailand, and Vietnam.
Black or African American (not Hispanic or Latino): A person having origins in any of the Black racial groups of Africa.
Native Hawaiian or Other Pacific Islander (not Hispanic or Latino): A person having origins in any of the Hawaii, Guam, Samoa, or other Pacific Islands.
White (not Hispanic or Latino): A person having origins in any of the original peoples of Europe, the Middle East,
or North Africa.
D. Two or More Races
Two or More Races (not Hispanic or Latino): All persons who identify with more than one of the above five races.
(Note: If "Two or More Races" is selected, you do not need to check another race designation.)
Thank you for your assistance. |
