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 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) 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. 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. (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. For non-Hispanics only:
Ethnicity. [Ethnicity] field contains Client doesn't know, Client refused, Data not collected, or is missing.
Ethnicity. Hispanic or Latino Not Hispanic or Latino Race American Indian or Alaskan Native Asian Black or African American Native Hawaiian or Other Pacific Islander White
