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\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid15021394\charrsid12739525 \trowd \irow0\irowband0\ltrrow\ts11\trqc\trgaph120\trrh457\trleft732\trbrdrt\brdrdb\brdrw15\brdrcf1 \trbrdrl\brdrdb\brdrw15\brdrcf1 
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\trftsWidth3\trwWidth10473\trftsWidthB3\trpaddl120\trpaddr120\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid14953809\tbllkborder\tbllkhdrrows\tbllkhdrcols\tblind852\tblindtype3 \clvertalc\clbrdrt\brdrdb\brdrw15\brdrcf1 \clbrdrl\brdrdb\brdrw15\brdrcf1 
\clbrdrb\brdrs\brdrw15\brdrcf1 \clbrdrr\brdrdb\brdrw15\brdrcf1 \cltxlrtb\clftsWidth3\clwWidth10473\clshdrawnil \cellx11205\row \ltrrow}\trowd \irow1\irowband1\ltrrow\ts11\trqc\trgaph120\trrh2109\trleft732\trbrdrt\brdrdb\brdrw15\brdrcf1 \trbrdrl
\brdrdb\brdrw15\brdrcf1 \trbrdrb\brdrdb\brdrw15\brdrcf1 \trbrdrr\brdrdb\brdrw15\brdrcf1 \trbrdrh\brdrs\brdrw15\brdrcf1 \trbrdrv\brdrs\brdrw15\brdrcf1 
\trftsWidth3\trwWidth10473\trftsWidthB3\trpaddl120\trpaddr120\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid14953809\tbllkborder\tbllkhdrrows\tbllkhdrcols\tblind852\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw15\brdrcf1 \clbrdrl\brdrdb\brdrw15\brdrcf1 
\clbrdrb\brdrs\brdrw15\brdrcf1 \clbrdrr\brdrdb\brdrw15\brdrcf1 \cltxlrtb\clftsWidth3\clwWidth10473\clshdrawnil \cellx11205\pard \ltrpar\ql \li0\ri0\sb90\widctlpar\intbl
\tx-720\wrapdefault\hyphpar0\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid15021394 {\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid15021394\charrsid14156851 
\par }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\tx-720\wrapdefault\hyphpar0\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid15021394 {\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid15021394\charrsid14156851 
Sponsor:  ________________________________________________________________
\par 
\par Site: ____________________________________________________________________
\par 
\par Address:  ________________________________________________________________
\par 
\par Site supervisor:  __________________________________________________________
\par }\pard \ltrpar\ql \li0\ri0\sa54\widctlpar\intbl\tx-720\wrapdefault\hyphpar0\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid15021394 {\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid15021394\charrsid14156851 \cell }\pard \ltrpar
\ql \li0\ri0\sa200\sl276\slmult1\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid15021394\charrsid12739525 \trowd \irow1\irowband1\ltrrow\ts11\trqc\trgaph120\trrh2109\trleft732\trbrdrt
\brdrdb\brdrw15\brdrcf1 \trbrdrl\brdrdb\brdrw15\brdrcf1 \trbrdrb\brdrdb\brdrw15\brdrcf1 \trbrdrr\brdrdb\brdrw15\brdrcf1 \trbrdrh\brdrs\brdrw15\brdrcf1 \trbrdrv\brdrs\brdrw15\brdrcf1 
\trftsWidth3\trwWidth10473\trftsWidthB3\trpaddl120\trpaddr120\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid14953809\tbllkborder\tbllkhdrrows\tbllkhdrcols\tblind852\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw15\brdrcf1 \clbrdrl\brdrdb\brdrw15\brdrcf1 
\clbrdrb\brdrs\brdrw15\brdrcf1 \clbrdrr\brdrdb\brdrw15\brdrcf1 \cltxlrtb\clftsWidth3\clwWidth10473\clshdrawnil \cellx11205\row \ltrrow}\trowd \irow2\irowband2\ltrrow\ts11\trqc\trgaph120\trrh574\trleft732\trbrdrt\brdrdb\brdrw15\brdrcf1 \trbrdrl
\brdrdb\brdrw15\brdrcf1 \trbrdrb\brdrdb\brdrw15\brdrcf1 \trbrdrr\brdrdb\brdrw15\brdrcf1 \trbrdrh\brdrs\brdrw15\brdrcf1 \trbrdrv\brdrs\brdrw15\brdrcf1 
\trftsWidth3\trwWidth10473\trftsWidthB3\trpaddl120\trpaddr120\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid14953809\tbllkborder\tbllkhdrrows\tbllkhdrcols\tblind852\tblindtype3 \clvertalc\clbrdrt\brdrs\brdrw15\brdrcf1 \clbrdrl\brdrdb\brdrw15\brdrcf1 
\clbrdrb\brdrs\brdrw15\brdrcf1 \clbrdrr\brdrs\brdrw15\brdrcf1 \cltxlrtb\clftsWidth3\clwWidth5791\clshdrawnil \cellx6523\clvertalc\clbrdrt\brdrs\brdrw15\brdrcf1 \clbrdrl\brdrs\brdrw15\brdrcf1 \clbrdrb\brdrs\brdrw15\brdrcf1 \clbrdrr\brdrdb\brdrw15\brdrcf1 
\cltxlrtb\clftsWidth3\clwWidth4682\clshdrawnil \cellx11205\pard \ltrpar\qc \li0\ri0\sb90\sa54\widctlpar\intbl\tqc\tx3170\wrapdefault\hyphpar0\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid15021394 {\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 
\b\fs20\insrsid15021394\charrsid15021394 Ethnic Categories\cell }\pard \ltrpar\qc \li0\ri0\sb90\widctlpar\intbl\tqc\tx1346\wrapdefault\hyphpar0\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid15021394 {\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 
\b\fs20\insrsid15021394\charrsid7875426 Number of
\par }\pard \ltrpar\qc \li0\ri0\sa54\widctlpar\intbl\tqc\tx1346\wrapdefault\hyphpar0\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid15021394 {\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\fs20\insrsid15021394\charrsid7875426 Participating Children}{
\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\highlight7\insrsid15021394\charrsid10442926 \cell }\pard \ltrpar\ql \li0\ri0\sa200\sl276\slmult1\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 
\insrsid15021394\charrsid12739525 \trowd \irow2\irowband2\ltrrow\ts11\trqc\trgaph120\trrh574\trleft732\trbrdrt\brdrdb\brdrw15\brdrcf1 \trbrdrl\brdrdb\brdrw15\brdrcf1 \trbrdrb\brdrdb\brdrw15\brdrcf1 \trbrdrr\brdrdb\brdrw15\brdrcf1 \trbrdrh
\brdrs\brdrw15\brdrcf1 \trbrdrv\brdrs\brdrw15\brdrcf1 \trftsWidth3\trwWidth10473\trftsWidthB3\trpaddl120\trpaddr120\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid14953809\tbllkborder\tbllkhdrrows\tbllkhdrcols\tblind852\tblindtype3 \clvertalc\clbrdrt
\brdrs\brdrw15\brdrcf1 \clbrdrl\brdrdb\brdrw15\brdrcf1 \clbrdrb\brdrs\brdrw15\brdrcf1 \clbrdrr\brdrs\brdrw15\brdrcf1 \cltxlrtb\clftsWidth3\clwWidth5791\clshdrawnil \cellx6523\clvertalc\clbrdrt\brdrs\brdrw15\brdrcf1 \clbrdrl\brdrs\brdrw15\brdrcf1 \clbrdrb
\brdrs\brdrw15\brdrcf1 \clbrdrr\brdrdb\brdrw15\brdrcf1 \cltxlrtb\clftsWidth3\clwWidth4682\clshdrawnil \cellx11205\row \ltrrow}\trowd \irow3\irowband3\ltrrow\ts11\trqc\trgaph120\trrh1019\trleft732\trbrdrt\brdrdb\brdrw15\brdrcf1 \trbrdrl
\brdrdb\brdrw15\brdrcf1 \trbrdrb\brdrdb\brdrw15\brdrcf1 \trbrdrr\brdrdb\brdrw15\brdrcf1 \trbrdrh\brdrs\brdrw15\brdrcf1 \trbrdrv\brdrs\brdrw15\brdrcf1 
\trftsWidth3\trwWidth10473\trftsWidthB3\trpaddl120\trpaddr120\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid14953809\tbllkborder\tbllkhdrrows\tbllkhdrcols\tblind852\tblindtype3 \clvertalc\clbrdrt\brdrs\brdrw15\brdrcf1 \clbrdrl\brdrdb\brdrw15\brdrcf1 
\clbrdrb\brdrs\brdrw15\brdrcf1 \clbrdrr\brdrs\brdrw15\brdrcf1 \cltxlrtb\clftsWidth3\clwWidth5791\clshdrawnil \cellx6523\clvertalc\clbrdrt\brdrs\brdrw15\brdrcf1 \clbrdrl\brdrs\brdrw15\brdrcf1 \clbrdrb\brdrs\brdrw15\brdrcf1 \clbrdrr\brdrdb\brdrw15\brdrcf1 
\cltxlrtb\clftsWidth3\clwWidth4682\clshdrawnil \cellx11205\pard \ltrpar\ql \li0\ri0\sb90\sa54\widctlpar\intbl\tqc\tx3170\wrapdefault\hyphpar0\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid15021394 {\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 
\b\fs20\insrsid15021394\charrsid15021394 Hispanic or Latino.  }{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid15021394\charrsid15021394 
A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race.  The term \'93Spanish origin\'94 can be used in addition to \'93Hispanic or Latino.\'94}{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 
\b\fs20\insrsid15021394\charrsid15021394 \cell }\pard \ltrpar\qc \li0\ri0\sb90\widctlpar\intbl\tqc\tx1346\wrapdefault\hyphpar0\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid15021394 {\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 
\b\fs20\highlight7\insrsid15021394\charrsid10442926 \cell }\pard \ltrpar\ql \li0\ri0\sa200\sl276\slmult1\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid15021394\charrsid12739525 
\trowd \irow3\irowband3\ltrrow\ts11\trqc\trgaph120\trrh1019\trleft732\trbrdrt\brdrdb\brdrw15\brdrcf1 \trbrdrl\brdrdb\brdrw15\brdrcf1 \trbrdrb\brdrdb\brdrw15\brdrcf1 \trbrdrr\brdrdb\brdrw15\brdrcf1 \trbrdrh\brdrs\brdrw15\brdrcf1 \trbrdrv
\brdrs\brdrw15\brdrcf1 \trftsWidth3\trwWidth10473\trftsWidthB3\trpaddl120\trpaddr120\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid14953809\tbllkborder\tbllkhdrrows\tbllkhdrcols\tblind852\tblindtype3 \clvertalc\clbrdrt\brdrs\brdrw15\brdrcf1 \clbrdrl
\brdrdb\brdrw15\brdrcf1 \clbrdrb\brdrs\brdrw15\brdrcf1 \clbrdrr\brdrs\brdrw15\brdrcf1 \cltxlrtb\clftsWidth3\clwWidth5791\clshdrawnil \cellx6523\clvertalc\clbrdrt\brdrs\brdrw15\brdrcf1 \clbrdrl\brdrs\brdrw15\brdrcf1 \clbrdrb\brdrs\brdrw15\brdrcf1 \clbrdrr
\brdrdb\brdrw15\brdrcf1 \cltxlrtb\clftsWidth3\clwWidth4682\clshdrawnil \cellx11205\row \ltrrow}\trowd \irow4\irowband4\ltrrow\ts11\trqc\trgaph120\trrh1276\trleft732\trbrdrt\brdrdb\brdrw15\brdrcf1 \trbrdrl\brdrdb\brdrw15\brdrcf1 \trbrdrb
\brdrdb\brdrw15\brdrcf1 \trbrdrr\brdrdb\brdrw15\brdrcf1 \trbrdrh\brdrs\brdrw15\brdrcf1 \trbrdrv\brdrs\brdrw15\brdrcf1 
\trftsWidth3\trwWidth10473\trftsWidthB3\trpaddl120\trpaddr120\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid14953809\tbllkborder\tbllkhdrrows\tbllkhdrcols\tblind852\tblindtype3 \clvertalc\clbrdrt\brdrs\brdrw15\brdrcf1 \clbrdrl\brdrdb\brdrw15\brdrcf1 
\clbrdrb\brdrs\brdrw15\brdrcf1 \clbrdrr\brdrs\brdrw15\brdrcf1 \cltxlrtb\clftsWidth3\clwWidth5791\clshdrawnil \cellx6523\clvertalc\clbrdrt\brdrs\brdrw15\brdrcf1 \clbrdrl\brdrs\brdrw15\brdrcf1 \clbrdrb\brdrs\brdrw15\brdrcf1 \clbrdrr\brdrdb\brdrw15\brdrcf1 
\cltxlrtb\clftsWidth3\clwWidth4682\clshdrawnil \cellx11205\pard \ltrpar\ql \li0\ri0\sb90\sa54\widctlpar\intbl\tqc\tx3170\wrapdefault\hyphpar0\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid15021394 {\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 
\b\fs20\insrsid15021394\charrsid15021394 Non-Hispanic or Latino}{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\fs20\insrsid15021394 
\par }{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\fs20\insrsid9110252 
\par }{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\fs20\insrsid14953809 
\par }{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\fs20\insrsid9110252\charrsid15021394 \cell }\pard \ltrpar\qc \li0\ri0\sb90\widctlpar\intbl\tqc\tx1346\wrapdefault\hyphpar0\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid15021394 {\rtlch\fcs1 \ab\af0\afs20 
\ltrch\fcs0 \b\fs20\highlight7\insrsid15021394\charrsid10442926 \cell }\pard \ltrpar\ql \li0\ri0\sa200\sl276\slmult1\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid15021394\charrsid12739525 
\trowd \irow4\irowband4\ltrrow\ts11\trqc\trgaph120\trrh1276\trleft732\trbrdrt\brdrdb\brdrw15\brdrcf1 \trbrdrl\brdrdb\brdrw15\brdrcf1 \trbrdrb\brdrdb\brdrw15\brdrcf1 \trbrdrr\brdrdb\brdrw15\brdrcf1 \trbrdrh\brdrs\brdrw15\brdrcf1 \trbrdrv
\brdrs\brdrw15\brdrcf1 \trftsWidth3\trwWidth10473\trftsWidthB3\trpaddl120\trpaddr120\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid14953809\tbllkborder\tbllkhdrrows\tbllkhdrcols\tblind852\tblindtype3 \clvertalc\clbrdrt\brdrs\brdrw15\brdrcf1 \clbrdrl
\brdrdb\brdrw15\brdrcf1 \clbrdrb\brdrs\brdrw15\brdrcf1 \clbrdrr\brdrs\brdrw15\brdrcf1 \cltxlrtb\clftsWidth3\clwWidth5791\clshdrawnil \cellx6523\clvertalc\clbrdrt\brdrs\brdrw15\brdrcf1 \clbrdrl\brdrs\brdrw15\brdrcf1 \clbrdrb\brdrs\brdrw15\brdrcf1 \clbrdrr
\brdrdb\brdrw15\brdrcf1 \cltxlrtb\clftsWidth3\clwWidth4682\clshdrawnil \cellx11205\row \ltrrow}\trowd \irow5\irowband5\ltrrow\ts11\trqc\trgaph120\trrh359\trleft732\trbrdrt\brdrdb\brdrw15\brdrcf1 \trbrdrl\brdrdb\brdrw15\brdrcf1 \trbrdrb
\brdrdb\brdrw15\brdrcf1 \trbrdrr\brdrdb\brdrw15\brdrcf1 \trbrdrh\brdrs\brdrw15\brdrcf1 \trbrdrv\brdrs\brdrw15\brdrcf1 
\trftsWidth3\trwWidth10473\trftsWidthB3\trpaddl120\trpaddr120\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid14953809\tbllkborder\tbllkhdrrows\tbllkhdrcols\tblind852\tblindtype3 \clvertalc\clbrdrt\brdrs\brdrw15\brdrcf1 \clbrdrl\brdrdb\brdrw15\brdrcf1 
\clbrdrb\brdrs\brdrw15\brdrcf1 \clbrdrr\brdrs\brdrw15\brdrcf1 \cltxlrtb\clftsWidth3\clwWidth5791\clshdrawnil \cellx6523\clvertalc\clbrdrt\brdrs\brdrw15\brdrcf1 \clbrdrl\brdrs\brdrw15\brdrcf1 \clbrdrb\brdrs\brdrw15\brdrcf1 \clbrdrr\brdrdb\brdrw15\brdrcf1 
\cltxlrtb\clftsWidth3\clwWidth4682\clshdrawnil \cellx11205\pard \ltrpar\qc \li0\ri0\sb90\sa54\widctlpar\intbl\tqc\tx3170\wrapdefault\hyphpar0\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid15021394 {\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 
\b\fs20\insrsid15021394 Racial Categories}{\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\fs20\insrsid15021394\charrsid14156851 \cell }\pard \ltrpar\qc \li0\ri0\sb90\widctlpar\intbl
\tqc\tx1346\wrapdefault\hyphpar0\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid15021394 {\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 \b\fs20\insrsid15021394\charrsid14156851 \cell }\pard \ltrpar\ql \li0\ri0\sa200\sl276\slmult1
\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid15021394\charrsid12739525 \trowd \irow5\irowband5\ltrrow\ts11\trqc\trgaph120\trrh359\trleft732\trbrdrt\brdrdb\brdrw15\brdrcf1 \trbrdrl
\brdrdb\brdrw15\brdrcf1 \trbrdrb\brdrdb\brdrw15\brdrcf1 \trbrdrr\brdrdb\brdrw15\brdrcf1 \trbrdrh\brdrs\brdrw15\brdrcf1 \trbrdrv\brdrs\brdrw15\brdrcf1 
\trftsWidth3\trwWidth10473\trftsWidthB3\trpaddl120\trpaddr120\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid14953809\tbllkborder\tbllkhdrrows\tbllkhdrcols\tblind852\tblindtype3 \clvertalc\clbrdrt\brdrs\brdrw15\brdrcf1 \clbrdrl\brdrdb\brdrw15\brdrcf1 
\clbrdrb\brdrs\brdrw15\brdrcf1 \clbrdrr\brdrs\brdrw15\brdrcf1 \cltxlrtb\clftsWidth3\clwWidth5791\clshdrawnil \cellx6523\clvertalc\clbrdrt\brdrs\brdrw15\brdrcf1 \clbrdrl\brdrs\brdrw15\brdrcf1 \clbrdrb\brdrs\brdrw15\brdrcf1 \clbrdrr\brdrdb\brdrw15\brdrcf1 
\cltxlrtb\clftsWidth3\clwWidth4682\clshdrawnil \cellx11205\row \ltrrow}\trowd \irow6\irowband6\ltrrow\ts11\trqc\trgaph120\trrh1019\trleft732\trbrdrt\brdrdb\brdrw15\brdrcf1 \trbrdrl\brdrdb\brdrw15\brdrcf1 \trbrdrb\brdrdb\brdrw15\brdrcf1 \trbrdrr
\brdrdb\brdrw15\brdrcf1 \trbrdrh\brdrs\brdrw15\brdrcf1 \trbrdrv\brdrs\brdrw15\brdrcf1 
\trftsWidth3\trwWidth10473\trftsWidthB3\trpaddl120\trpaddr120\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid14953809\tbllkborder\tbllkhdrrows\tbllkhdrcols\tblind852\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw15\brdrcf1 \clbrdrl\brdrdb\brdrw15\brdrcf1 
\clbrdrb\brdrs\brdrw15\brdrcf1 \clbrdrr\brdrs\brdrw15\brdrcf1 \cltxlrtb\clftsWidth3\clwWidth5791\clshdrawnil \cellx6523\clvertalt\clbrdrt\brdrs\brdrw15\brdrcf1 \clbrdrl\brdrs\brdrw15\brdrcf1 \clbrdrb\brdrs\brdrw15\brdrcf1 \clbrdrr\brdrdb\brdrw15\brdrcf1 
\cltxlrtb\clftsWidth3\clwWidth4682\clshdrawnil \cellx11205\pard \ltrpar\ql \li0\ri0\sb90\sa54\widctlpar\intbl\tx-720\wrapdefault\hyphpar0\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid15021394 {\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 
\b\fs20\insrsid15021394\charrsid14156851 American Indian or {\*\xmlopen\xmlns2{\factoidname place}}{\*\xmlopen\xmlns2{\factoidname State}}Alaska{\*\xmlclose}{\*\xmlclose} Native}{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid15021394\charrsid14156851 
.  A person having origins in any of the original peoples of North and South America, (including {\*\xmlopen\xmlns2{\factoidname place}}Central America{\*\xmlclose}), and who maintains tribal affiliation or community recognition.\cell \cell }\pard \ltrpar
\ql \li0\ri0\sa200\sl276\slmult1\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid15021394\charrsid12739525 \trowd \irow6\irowband6\ltrrow\ts11\trqc\trgaph120\trrh1019\trleft732\trbrdrt
\brdrdb\brdrw15\brdrcf1 \trbrdrl\brdrdb\brdrw15\brdrcf1 \trbrdrb\brdrdb\brdrw15\brdrcf1 \trbrdrr\brdrdb\brdrw15\brdrcf1 \trbrdrh\brdrs\brdrw15\brdrcf1 \trbrdrv\brdrs\brdrw15\brdrcf1 
\trftsWidth3\trwWidth10473\trftsWidthB3\trpaddl120\trpaddr120\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid14953809\tbllkborder\tbllkhdrrows\tbllkhdrcols\tblind852\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw15\brdrcf1 \clbrdrl\brdrdb\brdrw15\brdrcf1 
\clbrdrb\brdrs\brdrw15\brdrcf1 \clbrdrr\brdrs\brdrw15\brdrcf1 \cltxlrtb\clftsWidth3\clwWidth5791\clshdrawnil \cellx6523\clvertalt\clbrdrt\brdrs\brdrw15\brdrcf1 \clbrdrl\brdrs\brdrw15\brdrcf1 \clbrdrb\brdrs\brdrw15\brdrcf1 \clbrdrr\brdrdb\brdrw15\brdrcf1 
\cltxlrtb\clftsWidth3\clwWidth4682\clshdrawnil \cellx11205\row \ltrrow}\pard \ltrpar\ql \li0\ri0\sb90\sa54\widctlpar\intbl\tx-720\wrapdefault\hyphpar0\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid15021394 {\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 
\b\fs20\insrsid15021394\charrsid14156851 Asian.}{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid15021394\charrsid14156851 
  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.\cell 
}\pard\plain \ltrpar\s16\ql \li0\ri0\sb90\sa54\nowidctlpar\intbl\tx-720\wrapdefault\hyphpar0\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid15021394 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 
\f2\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af0 \ltrch\fcs0 \f0\fs20\insrsid15021394\charrsid14156851 \cell }\pard\plain \ltrpar\ql \li0\ri0\sa200\sl276\slmult1
\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid15021394\charrsid12739525 
\trowd \irow7\irowband7\ltrrow\ts11\trqc\trgaph120\trrh1019\trleft732\trbrdrt\brdrdb\brdrw15\brdrcf1 \trbrdrl\brdrdb\brdrw15\brdrcf1 \trbrdrb\brdrdb\brdrw15\brdrcf1 \trbrdrr\brdrdb\brdrw15\brdrcf1 \trbrdrh\brdrs\brdrw15\brdrcf1 \trbrdrv
\brdrs\brdrw15\brdrcf1 \trftsWidth3\trwWidth10473\trftsWidthB3\trpaddl120\trpaddr120\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid14953809\tbllkborder\tbllkhdrrows\tbllkhdrcols\tblind852\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw15\brdrcf1 \clbrdrl
\brdrdb\brdrw15\brdrcf1 \clbrdrb\brdrs\brdrw15\brdrcf1 \clbrdrr\brdrs\brdrw15\brdrcf1 \cltxlrtb\clftsWidth3\clwWidth5791\clshdrawnil \cellx6523\clvertalt\clbrdrt\brdrs\brdrw15\brdrcf1 \clbrdrl\brdrs\brdrw15\brdrcf1 \clbrdrb\brdrs\brdrw15\brdrcf1 \clbrdrr
\brdrdb\brdrw15\brdrcf1 \cltxlrtb\clftsWidth3\clwWidth4682\clshdrawnil \cellx11205\row \ltrrow}\pard \ltrpar\ql \li0\ri0\sb90\widctlpar\intbl\tx-720\wrapdefault\hyphpar0\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid15021394 {\rtlch\fcs1 
\ab\af0\afs20 \ltrch\fcs0 \b\fs20\insrsid15021394\charrsid14156851 Black or African American.}{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid15021394\charrsid14156851   A person having origins in any of the black racial groups of 
{\*\xmlopen\xmlns2{\factoidname place}}Africa{\*\xmlclose}.  Terms such as \'93Haitian\'94 or \'93Negro\'94 can be used in addition to \'93Black or African American.\'94
\par }\pard \ltrpar\ql \li0\ri0\sa54\widctlpar\intbl\tx-720\wrapdefault\hyphpar0\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid15021394 {\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid15021394\charrsid14156851 \cell }\pard \ltrpar
\ql \li0\ri0\sb90\sa54\widctlpar\intbl\tx-720\wrapdefault\hyphpar0\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid15021394 {\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid15021394\charrsid14156851 \cell }\pard \ltrpar
\ql \li0\ri0\sa200\sl276\slmult1\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid15021394\charrsid12739525 \trowd \irow8\irowband8\ltrrow\ts11\trqc\trgaph120\trrh1019\trleft732\trbrdrt
\brdrdb\brdrw15\brdrcf1 \trbrdrl\brdrdb\brdrw15\brdrcf1 \trbrdrb\brdrdb\brdrw15\brdrcf1 \trbrdrr\brdrdb\brdrw15\brdrcf1 \trbrdrh\brdrs\brdrw15\brdrcf1 \trbrdrv\brdrs\brdrw15\brdrcf1 
\trftsWidth3\trwWidth10473\trftsWidthB3\trpaddl120\trpaddr120\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid14953809\tbllkborder\tbllkhdrrows\tbllkhdrcols\tblind852\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw15\brdrcf1 \clbrdrl\brdrdb\brdrw15\brdrcf1 
\clbrdrb\brdrs\brdrw15\brdrcf1 \clbrdrr\brdrs\brdrw15\brdrcf1 \cltxlrtb\clftsWidth3\clwWidth5791\clshdrawnil \cellx6523\clvertalt\clbrdrt\brdrs\brdrw15\brdrcf1 \clbrdrl\brdrs\brdrw15\brdrcf1 \clbrdrb\brdrs\brdrw15\brdrcf1 \clbrdrr\brdrdb\brdrw15\brdrcf1 
\cltxlrtb\clftsWidth3\clwWidth4682\clshdrawnil \cellx11205\row \ltrrow}\trowd \irow9\irowband9\ltrrow\ts11\trqc\trgaph120\trrh746\trleft732\trbrdrt\brdrdb\brdrw15\brdrcf1 \trbrdrl\brdrdb\brdrw15\brdrcf1 \trbrdrb\brdrdb\brdrw15\brdrcf1 \trbrdrr
\brdrdb\brdrw15\brdrcf1 \trbrdrh\brdrs\brdrw15\brdrcf1 \trbrdrv\brdrs\brdrw15\brdrcf1 
\trftsWidth3\trwWidth10473\trftsWidthB3\trpaddl120\trpaddr120\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid14953809\tbllkborder\tbllkhdrrows\tbllkhdrcols\tblind852\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw15\brdrcf1 \clbrdrl\brdrdb\brdrw15\brdrcf1 
\clbrdrb\brdrs\brdrw15\brdrcf1 \clbrdrr\brdrs\brdrw15\brdrcf1 \cltxlrtb\clftsWidth3\clwWidth5791\clshdrawnil \cellx6523\clvertalt\clbrdrt\brdrs\brdrw15\brdrcf1 \clbrdrl\brdrs\brdrw15\brdrcf1 \clbrdrb\brdrs\brdrw15\brdrcf1 \clbrdrr\brdrdb\brdrw15\brdrcf1 
\cltxlrtb\clftsWidth3\clwWidth4682\clshdrawnil \cellx11205\pard \ltrpar\ql \li0\ri0\sb90\widctlpar\intbl\tx-720\wrapdefault\hyphpar0\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid15021394 {\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 
\b\fs20\insrsid15021394\charrsid14156851 Native Hawaiian or Other Pacific Islander.}{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid15021394\charrsid14156851   A person having origins in any of the original peoples of {\*\xmlopen\xmlns2{\factoidname 
State}}Hawaii{\*\xmlclose}, Guam, Samoa, or other {\*\xmlopen\xmlns2{\factoidname place}}{\*\xmlopen\xmlns2{\factoidname PlaceName}}Pacific{\*\xmlclose} {\*\xmlopen\xmlns2{\factoidname PlaceType}}Islands{\*\xmlclose}{\*\xmlclose}.\cell }\pard \ltrpar
\ql \li0\ri0\sb90\sa54\widctlpar\intbl\tx-720\wrapdefault\hyphpar0\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid15021394 {\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid15021394\charrsid14156851 \cell }\pard \ltrpar
\ql \li0\ri0\sa200\sl276\slmult1\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid15021394\charrsid12739525 \trowd \irow9\irowband9\ltrrow\ts11\trqc\trgaph120\trrh746\trleft732\trbrdrt
\brdrdb\brdrw15\brdrcf1 \trbrdrl\brdrdb\brdrw15\brdrcf1 \trbrdrb\brdrdb\brdrw15\brdrcf1 \trbrdrr\brdrdb\brdrw15\brdrcf1 \trbrdrh\brdrs\brdrw15\brdrcf1 \trbrdrv\brdrs\brdrw15\brdrcf1 
\trftsWidth3\trwWidth10473\trftsWidthB3\trpaddl120\trpaddr120\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid14953809\tbllkborder\tbllkhdrrows\tbllkhdrcols\tblind852\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw15\brdrcf1 \clbrdrl\brdrdb\brdrw15\brdrcf1 
\clbrdrb\brdrs\brdrw15\brdrcf1 \clbrdrr\brdrs\brdrw15\brdrcf1 \cltxlrtb\clftsWidth3\clwWidth5791\clshdrawnil \cellx6523\clvertalt\clbrdrt\brdrs\brdrw15\brdrcf1 \clbrdrl\brdrs\brdrw15\brdrcf1 \clbrdrb\brdrs\brdrw15\brdrcf1 \clbrdrr\brdrdb\brdrw15\brdrcf1 
\cltxlrtb\clftsWidth3\clwWidth4682\clshdrawnil \cellx11205\row \ltrrow}\trowd \irow10\irowband10\ltrrow\ts11\trqc\trgaph120\trrh1751\trleft732\trbrdrt\brdrdb\brdrw15\brdrcf1 \trbrdrl\brdrdb\brdrw15\brdrcf1 \trbrdrb\brdrdb\brdrw15\brdrcf1 \trbrdrr
\brdrdb\brdrw15\brdrcf1 \trbrdrh\brdrs\brdrw15\brdrcf1 \trbrdrv\brdrs\brdrw15\brdrcf1 
\trftsWidth3\trwWidth10473\trftsWidthB3\trpaddl120\trpaddr120\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid14953809\tbllkborder\tbllkhdrrows\tbllkhdrcols\tblind852\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw15\brdrcf1 \clbrdrl\brdrdb\brdrw15\brdrcf1 
\clbrdrb\brdrs\brdrw15\brdrcf1 \clbrdrr\brdrs\brdrw15\brdrcf1 \cltxlrtb\clftsWidth3\clwWidth5791\clshdrawnil \cellx6523\clvertalt\clbrdrt\brdrs\brdrw15\brdrcf1 \clbrdrl\brdrs\brdrw15\brdrcf1 \clbrdrb\brdrs\brdrw15\brdrcf1 \clbrdrr\brdrdb\brdrw15\brdrcf1 
\cltxlrtb\clftsWidth3\clwWidth4682\clshdrawnil \cellx11205\pard \ltrpar\ql \li0\ri0\sb90\widctlpar\intbl\tx-720\wrapdefault\hyphpar0\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid15021394 {\rtlch\fcs1 \ab\af0\afs20 \ltrch\fcs0 
\b\fs20\insrsid15021394\charrsid14156851 White}{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid15021394\charrsid14156851 .  A person having origins in any of the original peoples of Europe, the Middle East or {\*\xmlopen\xmlns2{\factoidname place}}
North Africa{\*\xmlclose}.}{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid15021394 
\par }{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid9110252 
\par 
\par }{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid14953809 
\par }{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid9110252\charrsid14156851 \cell }\pard \ltrpar\qc \li0\ri0\sb90\widctlpar\intbl\tx-720\wrapdefault\hyphpar0\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid15021394 {\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 
\fs20\insrsid15021394\charrsid14156851 \cell }\pard \ltrpar\ql \li0\ri0\sa200\sl276\slmult1\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid15021394\charrsid12739525 
\trowd \irow10\irowband10\ltrrow\ts11\trqc\trgaph120\trrh1751\trleft732\trbrdrt\brdrdb\brdrw15\brdrcf1 \trbrdrl\brdrdb\brdrw15\brdrcf1 \trbrdrb\brdrdb\brdrw15\brdrcf1 \trbrdrr\brdrdb\brdrw15\brdrcf1 \trbrdrh\brdrs\brdrw15\brdrcf1 \trbrdrv
\brdrs\brdrw15\brdrcf1 \trftsWidth3\trwWidth10473\trftsWidthB3\trpaddl120\trpaddr120\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid14953809\tbllkborder\tbllkhdrrows\tbllkhdrcols\tblind852\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw15\brdrcf1 \clbrdrl
\brdrdb\brdrw15\brdrcf1 \clbrdrb\brdrs\brdrw15\brdrcf1 \clbrdrr\brdrs\brdrw15\brdrcf1 \cltxlrtb\clftsWidth3\clwWidth5791\clshdrawnil \cellx6523\clvertalt\clbrdrt\brdrs\brdrw15\brdrcf1 \clbrdrl\brdrs\brdrw15\brdrcf1 \clbrdrb\brdrs\brdrw15\brdrcf1 \clbrdrr
\brdrdb\brdrw15\brdrcf1 \cltxlrtb\clftsWidth3\clwWidth4682\clshdrawnil \cellx11205\row \ltrrow}\trowd \irow11\irowband11\lastrow \ltrrow\ts11\trqc\trgaph120\trrh1074\trleft732\trbrdrt\brdrdb\brdrw15\brdrcf1 \trbrdrl\brdrdb\brdrw15\brdrcf1 \trbrdrb
\brdrdb\brdrw15\brdrcf1 \trbrdrr\brdrdb\brdrw15\brdrcf1 \trbrdrh\brdrs\brdrw15\brdrcf1 \trbrdrv\brdrs\brdrw15\brdrcf1 
\trftsWidth3\trwWidth10473\trftsWidthB3\trpaddl120\trpaddr120\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid14953809\tbllkborder\tbllkhdrrows\tbllkhdrcols\tblind852\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw15\brdrcf1 \clbrdrl\brdrdb\brdrw15\brdrcf1 
\clbrdrb\brdrdb\brdrw15\brdrcf1 \clbrdrr\brdrs\brdrw15\brdrcf1 \cltxlrtb\clftsWidth3\clwWidth5791\clshdrawnil \cellx6523\clvertalt\clbrdrt\brdrs\brdrw15\brdrcf1 \clbrdrl\brdrs\brdrw15\brdrcf1 \clbrdrb\brdrdb\brdrw15\brdrcf1 \clbrdrr
\brdrdb\brdrw15\brdrcf1 \cltxlrtb\clftsWidth3\clwWidth4682\clshdrawnil \cellx11205\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\brdrb\brdrs\brdrw30\brsp20 \tx-720\wrapdefault\hyphpar0\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid15021394 {\rtlch\fcs1 
\af0\afs20 \ltrch\fcs0 \fs20\insrsid15021394\charrsid14156851 
\par 
\par 
\par }\pard \ltrpar\ql \li0\ri0\sa54\widctlpar\intbl\tx-720\wrapdefault\hyphpar0\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid15021394 {\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid15021394\charrsid14156851 Monitor's Signature\cell }\pard \ltrpar
\ql \li0\ri0\widctlpar\intbl\tx-720\wrapdefault\hyphpar0\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid15021394 {\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid15021394\charrsid14156851 
\par }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\tqc\tx1346\wrapdefault\hyphpar0\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid15021394 {\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid15021394\charrsid14156851 
\par }{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \b\fs20\insrsid15021394\charrsid14156851 _____________________________
\par }\pard \ltrpar\ql \li0\ri0\sa54\widctlpar\intbl\tqc\tx1346\wrapdefault\hyphpar0\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid15021394 {\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid15021394\charrsid14156851 \tab    Date       \cell 
}\pard \ltrpar\ql \li0\ri0\sa200\sl276\slmult1\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid15021394\charrsid12739525 \trowd \irow11\irowband11\lastrow \ltrrow
\ts11\trqc\trgaph120\trrh1074\trleft732\trbrdrt\brdrdb\brdrw15\brdrcf1 \trbrdrl\brdrdb\brdrw15\brdrcf1 \trbrdrb\brdrdb\brdrw15\brdrcf1 \trbrdrr\brdrdb\brdrw15\brdrcf1 \trbrdrh\brdrs\brdrw15\brdrcf1 \trbrdrv\brdrs\brdrw15\brdrcf1 
\trftsWidth3\trwWidth10473\trftsWidthB3\trpaddl120\trpaddr120\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid14953809\tbllkborder\tbllkhdrrows\tbllkhdrcols\tblind852\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw15\brdrcf1 \clbrdrl\brdrdb\brdrw15\brdrcf1 
\clbrdrb\brdrdb\brdrw15\brdrcf1 \clbrdrr\brdrs\brdrw15\brdrcf1 \cltxlrtb\clftsWidth3\clwWidth5791\clshdrawnil \cellx6523\clvertalt\clbrdrt\brdrs\brdrw15\brdrcf1 \clbrdrl\brdrs\brdrw15\brdrcf1 \clbrdrb\brdrdb\brdrw15\brdrcf1 \clbrdrr
\brdrdb\brdrw15\brdrcf1 \cltxlrtb\clftsWidth3\clwWidth4682\clshdrawnil \cellx11205\row }\pard \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid14953809 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid15021394 

\par }\pard \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid14370372 {\rtlch\fcs1 \af0 \ltrch\fcs0 \cs20\cf1\chshdng0\chcfpat0\chcbpat8\insrsid14370372 
\par }{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \cs20\b\cf1\chshdng0\chcfpat0\chcbpat8\insrsid14370372\charrsid15344145 Instructions for Completing the Ethnic Racial Data Form
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs20\cf1\chshdng0\chcfpat0\chcbpat8\insrsid14370372\charrsid15344145 
\par The sponsor should complete this form for each site under its sponsorship each year. Sponsors of residential camps must collect this information for each camp session.\~}{\rtlch\fcs1 \af0 \ltrch\fcs0 
\cs21\cf1\chshdng0\chcfpat0\chcbpat8\insrsid14370372\charrsid15344145 \~
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid14370372\charrsid15344145 
\par On May 17th, 2021, USDA released\~}{\field\fldedit{\*\fldinst {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid14370372\charrsid15344145 
 HYPERLINK "https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Ffns-prod.azureedge.net%2Fsites%2Fdefault%2Ffiles%2Fresource-files%2FCACFP11_SFSP07s.pdf&data=04%7C01%7CAdriane.Ackroyd%40maine.gov%7C92a4eb64b6ff
4cacfca708d9268cf407%7C413fa8ab207d4b629bcdea1a8f2f864e%7C0%7C0%7C637583209396373695%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=u5CDRdsiX%2F%2B3y8ySa0Y864eqOD6kXpj7df3JJpQNAM4%3D&reserved=0" \\
t "_blank" }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid6706050\charrsid15344145 {\*\datafield 
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\rtlch\fcs1 \af0 \ltrch\fcs0 \cs18\ul\cf19\insrsid14370372\charrsid15344145 Program \endash  Policy Recission}}}\sectd \ltrsect\linex0\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9110252\sftnbj {\rtlch\fcs1 \af0 \ltrch\fcs0 
\insrsid14370372\charrsid15344145 \u8203\'3f. Racial and ethnic data is no longer to be\~collected by visual observation. 
\par 
\par }\pard \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid15344145 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid15344145\charrsid15344145 
Sponsors operating SFSP are still required to collect racial and ethnic data. Instead of using visual observation, the following are options to use to collect racial and ethnic data. 
\par {\listtext\pard\plain\ltrpar \s24 \rtlch\fcs1 \af0 \ltrch\fcs0 \dbch\af37\insrsid15344145\charrsid15344145 \hich\af0\dbch\af37\loch\f0 1)\tab}}\pard\plain \ltrpar\s24\ql \fi-360\li720\ri0\sa160\sl259\slmult1
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\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid15344145\charrsid15344145 \hich\af0\dbch\af37\loch\f0 If the sponsor uses free/reduced\hich\af0\dbch\af37\loch\f0 
 meal benefit applications, the racial and ethnic data collected on these forms can be used. All racial/ethnic application data obtained for the most recent operating year, can be used to estimate the breakdown of race/ethnicity on the racial/ethnic data 
\hich\af0\dbch\af37\loch\f0 f\hich\af0\dbch\af37\loch\f0 orm. 
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Use the National Center for Education Statistics website to estimate race/ethnicity on the area the site operates. Data can be found here: }{\field\fldedit{\*\fldinst {\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid15344145\charrsid15344145 
\hich\af0\dbch\af37\loch\f0  HYPERLINK "https://nces.ed.gov/programs/edge/TableViewer/acsProfile/2019" }}{\fldrslt {\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \cs18\f0\fs24\ul\cf19\insrsid15344145\charrsid15344145 \hich\af0\dbch\af37\loch\f0 
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\hich\af0\dbch\af37\loch\f0  
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\hich\af0\dbch\af37\loch\f0 Filter by school district, children, demographic data. Use the overall statistics to complete the form. 
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\insrsid15344145\charrsid15344145 Children must not be asked to identify their own race and ethnicity. 
\par }\pard\plain \ltrpar\s19\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faroman\adjustright\rin0\lin0\itap0\pararsid15344145 \rtlch\fcs1 \af37\afs22\alang1025 \ltrch\fcs0 \f37\fs22\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 
\af0\afs24 \ltrch\fcs0 \cs20\f0\fs24\insrsid15344145\charrsid15344145 All line items on this page must be answered numerically\~(no percentages). Do not use words\~such as\~\'93All\'94 or \'93None\'94.\~}{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 
\cs21\f0\fs24\insrsid15344145\charrsid15344145 \~
\par }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \f0\fs24\insrsid15344145\charrsid15344145 
\par }{\rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \cs20\f0\fs24\insrsid15344145\charrsid15344145 The sponsor must retain racial and ethnic data for three years, plus the current year, and must safeguard this information to prevent its use for discriminatory purposes.
\~Access to program records containing racial and ethnic data should be kept confidential and limited to authorized personnel.
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