How do you identify?
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Are you Hispanic or Latinx?
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Race/Ethnicity (choose all that apply): |
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If you identify as American Indian or Alaska Native, please indicate with which federally and/or state recognized tribe you are registered. If not registered, type 'Not Registered'
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Do you identify as LGBTQ (lesbian, bisexual, transgendered, or queer)?
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Have you been a member of the US armed forces?
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Do you have a physical or mental impairment that substantially limits one or more major life activities?
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Country of Citizenship:
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Which of the following represents your visa status?
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Are you authorized to work in the United States?
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Is your status in the United States one of the following: U.S. Citizen, Legal Permanent Resident, Asylee, Refugee, Temporary Resident (IRCA), or DACA (Deferred Action/Dream Act)?
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Are you under Deferred Action for Childhood Arrivals (DACA) policy?
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If you are NOT a U.S. Citizen, Legal Permanent Resident, Asylee, Refugee, Temporary Resident (IRCA), DACA status, or an international student with an F-1 visa, indicate your status below:
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