Ethnicity/Race Questionnaire

Please complete the survey questions.
 
*1: Name (last name, first name):   
2: School:   








( Up to 9 choices are allowed )
*3: Are you Hispanic/Latino?   

*4: What is your race? (Choose one or more)   




( Up to 5 choices are allowed )
 
Survey By: LH 6/10/2009
 
Created on 6/11/2009 3:18:33 PM - Last updated on9/21/2009 9:37:13 AM