Common use of Ethnicity Clause in Contracts

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 NAME (Last, First) PHONE Home: Mobile: EMAIL XXXXXXX XXXXXX XXXXXXX XXXX, XXXXX, ZIP CODE GOVERNMENT OFFICIAL COMPLETES THIS SECTION AGENCY CONTACT NAME (Last, First) AGENCY CONTACT EMAIL & PHONE REIMBURSEMENTS APPROVED: Yes No Type and Rate of Reimbursement: VOLUNTEER POSITION/GROUP PROJECT TITLE:

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 XXXXXXX 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: Yes No Type and Rate of Reimbursement: Yes No 23. VOLUNTEER POSITION/GROUP PROJECT TITLE:

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 XXXXXXX 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: Yes No Type and Rate of Reimbursement: Yes No 23. VOLUNTEER POSITION/GROUP PROJECT TITLE:

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 XXXXXXX ADDRESS 18. XXXXXX XXXXXXX 00. XXXX, XXXXX, ZIP CODE GOVERNMENT OFFICIAL COMPLETES THIS SECTION 20. AGENCY CONTACT NAME (Last, First) Xxxxxxx, Xxxx 21. AGENCY CONTACT EMAIL & PHONE REIMBURSEMENTS APPROVED: Yes No Type and Rate of Reimbursement: VOLUNTEER POSITION/GROUP PROJECT TITLE:Xxxx_Xxxxxxx@xxx.xxx 510‐792‐0222, x361

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 XXXXXXX ADDRESS 18. XXXXXX XXXXXXX 00. XXXX, XXXXX, ZIP CODE GOVERNMENT OFFICIAL COMPLETES THIS SECTION 20. AGENCY CONTACT NAME (Last, First) Xxxxxxxx, Xxxxxxx 21. AGENCY CONTACT EMAIL & PHONE REIMBURSEMENTS APPROVED: Yes No Type and Rate of Reimbursement: VOLUNTEER POSITION/GROUP PROJECT TITLE:Xxxxxxx_Xxxxxxxx@xxx.xxx; 000-000-0000

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 XXXXXXX ADDRESS 18. XXXXXX XXXXXXX 00. XXXX, XXXXX, ZIP CODE GOVERNMENT OFFICIAL COMPLETES THIS SECTION 20. AGENCY CONTACT NAME (Last, First) XxXxxxxxx, Xxxxx 21. AGENCY CONTACT EMAIL & PHONE REIMBURSEMENTS APPROVED: Yes No Type and Rate of Reimbursement: VOLUNTEER POSITION/GROUP PROJECT TITLE:xxxxxxxx@xxx.xxx

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 XXXXXXX 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: Yes No No Type and Rate of Reimbursement: 23. VOLUNTEER POSITION/GROUP PROJECT TITLE: