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First Name
Middle Initial
Last Name
E-mail
Phone
Approx. Date of Availability
Gender
Female
Male
Race or Ethnic Group
AMERICAN INDIAN OR ALASKAN NATIVE (Not Hispanic or Latino) A person having origins in any of the original peoples of North America and South America (including Central America) and who maintain tribal affiliation 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 original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.
WHITE (Not Hispanic or Latino) A person having origins in any of the original peoples of Europe, North Africa, or the Middle East.
TWO OR MORE RACES (Not Hispanic or Latino) Please check all that applyAll persons who identify with more than one of the above five races.
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