Race and Ethnicity Description Test Form

Race and Ethnicity Description Test Form

Check all that apply AND print details in the spaces below. You may report more than one group.
Race

WhiteHispanic, Latino, or SpanishOther
White Ethnicity

GermanItalianIrishPolishEnglishFrenchPrint, for example, Scottish, Norwegian, Dutch, etc.
Hispanic, Latino, or Spanish Ethnicity

Mexican or Mexican AmericanSalvadorianPuerto RicanDominicanCubanColombianPrint, for example, Guatemalan, Spaniard, Ecuadorian, etc.
Some Other Race, Ethnicity, or Origin
Should be Empty: