[] White
[] Black
[] African Am. or Negro
[] American Indian or Alaska Native
Print name of enrolled or principal tribe ____
[] Asian Indian
[] Japanese
[] Native Hawaiian
[] Chinese
[] Korean
[] Guamanian or Chamorro
[] Filipino
[] Vietnamese
[] Samoan
[] Other Asian Print race: ____
[] Other Pacific Islander Print race, for example, for example, Hmong, Laotian, Fijian, Tongan, and so on: ____
Thai, Pakistani, Cambodian, and so on. ____
[] Some other race Print race. ____