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Seattle CiviForm
Note: Fields marked with a * are required.
What is your race?
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American Indian/Alaska Native
Asian
Black/African American
Hispanic/Latino of any race
Native Hawaiian/Other Pacific Islander
North African/Middle Eastern
White
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Are you of Hispanic, Latina/Latino/Latinx or Spanish origin?
Please select one box
No, not of Hispanic, Latina/Latino/Latinx, or Spanish origin
Yes, of Hispanic, Latina/Latino/Latinx, or Spanish origin