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Race: (circle) American Indian Asian/PacificIslander Black White Other Ethnicity: (circle) Hispanic NonHispanicBF Intent Knowledge (self report) BASES Written Feeding Play NY N U Nothing Little Some
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- Tick the corresponding boxes that represent your race or ethnicity. If you identify as American Indian, Asian, Pacific Islander, Black, White, or any other race mentioned, mark the respective box.
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- If your race or ethnicity isn't listed, check if there is an 'other' option provided. If yes, choose the 'other' box and specify your race or ethnicity in the space provided.
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Race:(circle)American IndianAsian/Pacific-IslanderBlackWhiteOther template instructions

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Racecircleamerican indianasianpacific-islanderblackwhiteoformr refers to the categories used for reporting race and ethnicity information on forms.
Individuals and organizations that collect demographic data may require filers to provide racecircleamerican indianasianpacific-islanderblackwhiteoformr information.
Individuals can fill out racecircleamerican indianasianpacific-islanderblackwhiteoformr checkboxes or write in their race/ethnicity.
The purpose of racecircleamerican indianasianpacific-islanderblackwhiteoformr is to gather data on the racial and ethnic composition of a population.
Individuals may be asked to report their race or ethnicity as American Indian, Asian, Pacific Islander, Black, White, or another category on racecircleamerican indianasianpacific-islanderblackwhiteoformr.
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