Civil Rights Data Collection Form Sample Contracts

Organizations Name: Agreement:
Civil Rights Data Collection Form • July 21st, 2014

The following information must be collected each year to meet the Civil Rights requirements. The Center/Sponsor must return this to CYFD-Family Nutrition Bureau along with the Agreement renewal every year. Race and ethnic background data for the children enrolled at each center should be maintained confidentially and should only be made available to authorized State Agency or Federal personnel.

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