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SECTION I - GENERAL INFORMATION 1. DATE OF BIRTH (Mo, Day, Yr.) 2. GENDER FEMALE 3. U.S. CITIZEN MALE 4. RACE (Please check all that apply) 1. AMERICAN INDIAN or ALASKAN NATIVE 4. WHITE 5. YES 2. ASIAN If No, City and Country of Birth: PERMANENT RESIDENT NO 3. 4a. ETHNICITY BLACK or AFRICAN AMERICAN HISPANIC or LATINO NOT HISPANIC or LATINO NATIVE HAWAIIAN or PACIFIC ISLANDER 6. STUDENT IDENTIFICATION (SID) NUMBER 5. PLEASE PRINT YOUR NAME (Last, First, Middle, Suffix) 7. HOME M.

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