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N I and 12 Week Courses only. LAST NAME B.U.I.D./SOCIAL SECURITY NUMBER FIRST NAME MIDDLE INITIAL DATE OF BIRTH MO. DAY M MALE F FEMALE SEX EMAIL ADDRESS YR. Students are reminded that in accordance with the Code of Student Responsibilities (Appendix 15), current addresses must be on file with the University. ETHNICITY A D D R E S S (REQUIRED FOR GOVERNMENT REPORTS) STREET & CITY ARE YOU HISPANIC / LATINO? YES NO (CHECK ALL THAT APPLY) STATE ZIP COUNTRY (IF FO.

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