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Ethnicity Print Your name

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Country of origin: US
File type: PDF

U.S.A. forms for College of Wooster

BROWSE COLLEGE OF WOOSTER FORMS

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W
The sole purpose of this form is to help The College of Wooster maintain statistics and gather accurate
information.
RACE, ETHNICITY & CITIZENSHIP SELF IDENTIFICATION INFORMATION
CITIZENSHIP & VISA STATUS:
US citizen
Dual US citizen
US permanent resident please list alien #_________________________________
Other citizenship please list country_____________________________________
F1
M1
J1
F2
M2
J2
Other not listed ___________
ETHNICITY:
Please choose YES or No to the following question: Are you Hispanic or Latino?
Yes, Hispanic or Latino- A person of Cuban, Mexican, Puerto Rican, South or Central American or other
Spanish culture or origin regardless of race.
No, not Hispanic or Latino
RACE:
Please choose all that apply:
WH- White- A person having origins in any of the original peoples of Europe, the Middle East or North Africa
BL- Black or African American- A person having origins in any of the black racial groups of Africa
HP- Hawaiian/Pacific Islander- A person having origins in any of the peoples of Hawaii, Guam, Samoa, or
other Pacific Islands
AS- Asian- 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
AN- American/Alaska Native- A person having origins in any of the original peoples of North and South
America (including Central America), and who maintains tribal affiliation or community attachment
Prefer not to disclose ethnicity/race
Print Name_________________________________________
Signature___________________________________________ Date___________________________________
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Ethnicity Print Your name

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Completed 18 November 2019

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