Ethnicity. 3. Gender
Ethnicity. (Select one): 12b. Race (Select one or more, regardless of ethnicity): 12c. Are you a Military Vetera D Hispanic, Latino, or Spanish Origin D Not Hispanic, Latino, or Spanish 1D American Indian or Alaskan Native D Black or African American D Asian D White Active Duty Military? Yes 12d. Do you have a disability? Yes 0 No 0 No Origin D Native Hawaiian or Other Pacific Islander EMERGENCY CONTACT INFORMATION 13. NAME (Last, First) 14. PHONE 15. EMAIL ADDRESS 16. STREET ADDRESS, XXX# 00. CITY 18. STATE 19. ZIP CODE GOVERNMENT OFFICIAL COMPLETES THIS SECTION 20. NAME OF AGENCY/ BUREAU 21. AGREEMENT# 22. AGENCY CONTACT NAME (Last, First) 23. AGENCY CONTACT EMAIL & PHONE 24. REIMBURSEMENTS APPROVED: D Yes Type and Rate of Reimbursement: D No
Ethnicity. This Contract shall not be executed until the Contractor has completed the Minority/Ethnicity Form.
Ethnicity. (Select one): Hispanic or Latino Not Hispanic or Latino 14b. Race (Select one or more, regardless of ethnicity): American Indian or Alaskan Native Asian Black or African American White Native Hawaiian or Other Pacific Islander 14c. Are you a Veteran? Yes No 14d. Do you have disability? Yes No EMERGENCY CONTACT INFORMATION 15. NAME (Last, First) 16. PHONE Home: Mobile: 17. EMAIL ADDRESS
Ethnicity. (Select one): Hispanic or Latino Not Hispanic or Latino 14b. Race (Select one or more, regardless of ethnicity): American Indian or Alaskan Native Asian Black or African American White Native Hawaiian or Other Pacific Islander 14c. Are you a Veteran? Yes No 14d. Do you have a disability? Yes No EMERGENCY CONTACT INFORMATION 15. NAME (Last, First) 16. PHONE Home: Mobile: 17. EMAIL ADDRESS 18. XXXXXX XXXXXXX 00. XXXX, XXXXX, ZIP CODE GOVERNMENT OFFICIAL COMPLETES THIS SECTION 20. AGENCY CONTACT NAME (Last, First) 21. AGENCY CONTACT EMAIL & PHONE 22. REIMBURSEMENTS APPROVED: Type and Rate of Reimbursement: Yes No 23. VOLUNTEER POSITION/GROUP PROJECT TITLE:
Ethnicity. Are you … (check all that apply) eth1 Aboriginal (e.g., status, non-status, Métis, Inuit) ☐ eth2 Arab (e.g., Saudi, Egyptian, etc.) ☐ eth3 Black ☐ eth4 Chinese ☐ eth5 Filipino ☐ eth6 Japanese ☐ eth7 Korean ☐ eth8 Latin American ☐ eth9 South Asian (e.g., East Indian, Pakistani, Sri Lankan, etc.) ☐ eth10 Southeast Asian (e.g., Cambodian, Indonesian, Laotian, Vietnamese, etc.) ☐ eth11 West Asian (e.g., Afghan, Iranian, etc.) ☐ eth12 White ☐ eth13 Other (please specify below): ☐ ethtxt [If eth1 = “Aboriginal” branch to ab1, otherwise branch to the Comments section.] Which of the following describes your Aboriginal background? ab1 First Nations status ☐ ab2 First Nations non-status ☐ ab3 Metis ☐ ab4 Inuit ☐ ab5 Other ☐ Please take this opportunity to comment fully about your overall university experience. Your remarks will provide valuable information to the institution. negativ Looking back on your experiences as a student, what aspects of your experience at <university name> have been most negative? How could we have helped or done a better job? positiv Looking back on your experiences as a student, what aspects of your experience at <university name> have been most positive?
Ethnicity. For non-Hispanics only:
Ethnicity. (Select one): Hispanic or Latino Not Hispanic or Latino 14b. Race (Select one or more, regardless of ethnicity): American Indian or Alaskan Native Asian Black or African American White Native Hawaiian or Other Pacific Islander 14c. Are you a Veteran? Yes No 14d. Do you have disability? Yes No EMERGENCY CONTACT INFORMATION 15. NAME (Last, First) 16. PHONE Home: Mobile: 17. EMAIL ADDRESS 18. STREET ADDRESS 19. CITY, STATE, ZIP CODE GOVERNMENT OFFICIAL COMPLETES THIS SECTION 20. AGENCY CONTACT NAME (Last, First) Xxxxxx, Xxxxxx 21. AGENCY CONTACT EMAIL & PHONE 000-000-0000 xxxxxx_xxxxxx@xxx.xxx 22. REIMBURSEMENTS APPROVED: Yes No Type and Rate of Reimbursement: N/A 23. VOLUNTEER POSITION/GROUP PROJECT TITLE: Ice Age NST Volunteer
Ethnicity. [Ethnicity] field contains Client doesn't know, Client refused, Data not collected, or is missing.
Ethnicity. 9. Number of current children;
