Questionnaire Text

2016 ACS 2011 ACS 2006 ACS 2001 ACS
2015 ACS 2010 ACS 2005 ACS 2000 5%
2014 ACS 2009 ACS 2004 ACS
2013 ACS 2008 ACS 2003 ACS
2012 ACS 2007 ACS 2002 ACS
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2016 ACS
Questionnaire form view entire document:  text  image

6. What is Person X's race? Mark (X) one or more boxes.
[ ] White
[ ] Black or African Am.
[ ] American Indian or Alaska Native -- Print name of enrolled or principal tribe. --> __________________
[ ] Asian Indian
[ ] Japanese
[ ] Chinese
[ ] Korean
[ ] Filipino
[ ] Vietnamese
[ ] Other Asian -- Print race, for example, Hmong, Laotian, Thai, Pakistani, Cambodian, and so on._________________________
[ ] Native Hawaiian
[ ] Guamanian or Chamorro
[ ] Samoan
[ ] Other Pacific Islander -- Print race, for example, Fijian, Tongan, and so on.
[ ] Some other race -- Print race. --> ____________________________________________________
Questionnaire instructions view entire document:  text  image

6. Mark all boxes for the appropriate races.
The concept of race, as used by the Census Bureau, reflects self-identification by individuals according to the race or races with which they identify.
The instruction before question 5, "For this survey, Hispanic origins are not races" reflects the federal government's treatment of Hispanic origin and race as separate and distinct concepts. People who identify their origin as Hispanic, Latino, or Spanish may be of any race.
People may choose to provide two or more races either by marking two or more race response boxes, by providing multiple write-in responses, or by some combination of marking boxes and writing in responses.
If you mark the "American Indian or Alaska Native" box, also print the name of the tribe(s) in which the person is enrolled. If the person is not enrolled in a tribe, print the name of the person's enrolled or principle tribe(s) in the space provided (for example, Navajo nation, Blackfeet Tribe, Muscogee (Creek) nation, Mayan, Doyon, native Village of Barrow Inupiat Traditional Government, and so on).
If you mark the "Other Asian" box, print the name of the specific Asian group(s) in the space provided (for example, Pakistani, Cambodian, Hmong, Laotian, Bangladeshi, and so on.)
If you mark the "Other Pacific Islander" box, print the name of the specific Pacific Islander group(s) in the space provided (for example, Tongan, Fijian, Marshallese, Palauan, Tahitian, Papua New Guinean, and so on.)
If you mark the "Some other race" box, print the race(s) or group(s) in the space provided.
This question should be answered by ALL persons.

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2015 ACS
Questionnaire form view entire document:  text  image

6. What is Person X's race? Mark (X) one or more boxes.
[ ] White
[ ] Black or African Am.
[ ] American Indian or Alaska Native -- Print name of enrolled or principal tribe. --> __________________
[ ] Asian Indian
[ ] Japanese
[ ] Chinese
[ ] Korean
[ ] Filipino
[ ] Vietnamese
[ ] Other Asian -- Print race, for example, Hmong, Laotian, Thai, Pakistani, Cambodian, and so on._________________________
[ ] Native Hawaiian
[ ] Guamanian or Chamorro
[ ] Samoan
[ ] Other Pacific Islander -- Print race, for example, Fijian, Tongan, and so on.
[ ] Some other race -- Print race. --> ____________________________________________________
Questionnaire instructions view entire document:  text  image

6. Mark all boxes for the appropriate races.
The concept of race, as used by the Census Bureau, reflects self-identification by individuals according to the race or races with which they identify.
The instruction before question 5, "For this survey, Hispanic origins are not races" reflects the federal government's treatment of Hispanic origin and race as separate and distinct concepts. People who identify their origin as Hispanic, Latino, or Spanish may be of any race.
People may choose to provide two or more races either by marking two or more race response boxes, by providing multiple write-in responses, or by some combination of marking boxes and writing in responses.
If you mark the "American Indian or Alaska Native" box, also print the name of the tribe(s) in which the person is enrolled. If the person is not enrolled in a tribe, print the name of the person's enrolled or principle tribe(s) in the space provided (for example, Navajo nation, Blackfeet Tribe, Muscogee (Creek) nation, Mayan, Doyon, native Village of Barrow Inupiat Traditional Government, and so on).
If you mark the "Other Asian" box, print the name of the specific Asian group(s) in the space provided (for example, Pakistani, Cambodian, Hmong, Laotian, Bangladeshi, and so on.)
If you mark the "Other Pacific Islander" box, print the name of the specific Pacific Islander group(s) in the space provided (for example, Tongan, Fijian, Marshallese, Palauan, Tahitian, Papua New Guinean, and so on.)
If you mark the "Some other race" box, print the race(s) or group(s) in the space provided.
This question should be answered by ALL persons.

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2014 ACS
Questionnaire form view entire document:  text  image

6. What is Person X's race? Mark (X) one or more boxes.
[ ] White
[ ] Black or African Am.
[ ] American Indian or Alaska Native -- Print name of enrolled or principal tribe. --> __________________
[ ] Asian Indian
[ ] Japanese
[ ] Chinese
[ ] Korean
[ ] Filipino
[ ] Vietnamese
[ ] Other Asian -- Print race, for example, Hmong, Laotian, Thai, Pakistani, Cambodian, and so on._________________________
[ ] Native Hawaiian
[ ] Guamanian or Chamorro
[ ] Samoan
[ ] Other Pacific Islander -- Print race, for example, Fijian, Tongan, and so on.
[ ] Some other race -- Print race. --> ____________________________________________________
Questionnaire instructions view entire document:  text  image

6.Mark all boxes for the appropriate races.

The concept of race, as used by the Census Bureau, reflects self-identification by individuals according to the race or races with which they identify.

The instruction before question 5, "For this survey, Hispanic origins are not races" reflects the federal government's treatment of Hispanic origin and race as separate and distinct concepts. People who identify their origin as Hispanic, Latino, or Spanish may be of any race.

People may choose to provide two or more races either by marking two or more race response boxes, by providing multiple write-in responses, or by some combination of marking boxes and writing in responses.

If you mark the "American Indian or Alaska Native" box, also print the name of the tribe(s) in which the person is enrolled. If the person is not enrolled in a tribe, print the name of the principal tribe.

If you mark the "Other Asian" box, print the name of the specific race(s) or group(s) in the space provided. The category "Other Asian" includes persons who identify themselves as Laotian, Thai, Pakistani, Cambodian, Sri Lankan, and so on.

If you mark the "Other Pacific Islander" box, print the name of the specific race(s) or group(s) in the space provided. The category "Other Pacific Islander" includes persons who identify themselves as Fijian, Tongan, Polynesian, Tahitian and so on.

If you mark the "Some other race" box, print the race(s) or group(s) in the space provided.

This question should be answered by ALL persons.


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2013 ACS
Questionnaire form view entire document:  text  image

6. What is Person X's race? Mark (X) one or more boxes.

[ ] White
[ ] Black, African Am., or Negro
[ ] American Indian or Alaska Native -- Print name of enrolled or principal tribe. --> __________________
[ ] Asian Indian
[ ] Japanese
[ ] Chinese
[ ] Korean
[ ] Filipino
[ ] Vietnamese
[ ] Other Asian -- Print race, for example, Hmong, Laotian, Thai, Pakistani, Cambodian and so on.
[ ] Native Hawaiian
[ ] Guamanian or Chamorro
[ ] Samoan
[ ] Other Pacific Islander –Print race, for example, Fijian, Tongan, and so on.
[ ] Some other race -- Print race. -->
____________________________________________________
Questionnaire instructions view entire document:  text  image

6.Mark all boxes for the appropriate races.

The concept of race, as used by the Census Bureau, reflects self-identification by individuals according to the race or races with which they identify.

The instruction before question 5, "For this survey, Hispanic origins are not races" reflects the federal government's treatment of Hispanic origin and race as separate and distinct concepts. People who identify their origin as Hispanic, Latino, or Spanish may be of any race.

People may choose to provide two or more races either by marking two or more race response boxes, by providing multiple write-in responses, or by some combination of marking boxes and writing in responses.

If you mark the "American Indian or Alaska Native" box, also print the name of the tribe(s) in which the person is enrolled. If the person is not enrolled in a tribe, print the name of the principal tribe.

If you mark the "Other Asian" box, print the name of the specific race(s) or group(s) in the space provided. The category "Other Asian" includes persons who identify themselves as Laotian, Thai, Pakistani, Cambodian, Sri Lankan, and so on.

If you mark the "Other Pacific Islander" box, print the name of the specific race(s) or group(s) in the space provided. The category "Other Pacific Islander" includes persons who identify themselves as Fijian, Tongan, Polynesian, Tahitian and so on.

If you mark the "Some other race" box, print the race(s) or group(s) in the space provided.

This question should be answered by ALL persons.


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2012 ACS
Questionnaire form view entire document:  text  image

6. What is Person 1's race? Mark (X) one or more boxes.

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

[Repeat for persons X = 2 - 5.]

Questionnaire instructions view entire document:  text  image

6.Mark all boxes for the appropriate races.

The concept of race, as used by the Census Bureau, reflects self-identification by individuals according to the race or races with which they identify.

The instruction before question 5, "For this survey, Hispanic origins are not races" reflects the federal government's treatment of Hispanic origin and race as separate and distinct concepts. People who identify their origin as Hispanic, Latino, or Spanish may be of any race.

People may choose to provide two or more races either by marking two or more race response boxes, by providing multiple write-in responses, or by some combination of marking boxes and writing in responses.

If you mark the "American Indian or Alaska Native" box, also print the name of the tribe(s) in which the person is enrolled. If the person is not enrolled in a tribe, print the name of the principal tribe.

If you mark the "Other Asian" box, print the name of the specific race(s) or group(s) in the space provided. The category "Other Asian" includes persons who identify themselves as Laotian, Thai, Pakistani, Cambodian, Sri Lankan, and so on.

If you mark the "Other Pacific Islander" box, print the name of the specific race(s) or group(s) in the space provided. The category "Other Pacific Islander" includes persons who identify themselves as Fijian, Tongan, Polynesian, Tahitian and so on.

If you mark the "Some other race" box, print the race(s) or group(s) in the space provided.

This question should be answered by ALL persons.


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2011 ACS
Questionnaire form view entire document:  text  image

6. What is Person X's race? Mark (X) one or more boxes.

[ ] White
[ ] Black, African Am., or Negro
[ ] American Indian or Alaska Native -- Print name of enrolled or principal tribe. --> __________________
[ ] Asian Indian
[ ] Japanese
[ ] Chinese
[ ] Korean
[ ] Filipino
[ ] Vietnamese
[ ] Other Asian -- Print race, for example, Hmong, Laotian, Thai, Pakistani, Cambodian and so on.
[ ] Native Hawaiian
[ ] Guamanian or Chamorro
[ ] Samoan
[ ] Other Pacific Islander –Print race, for example, Fijian, Tongan, and so on.
[ ] Some other race -- Print race. -->
____________________________________________________
Questionnaire instructions view entire document:  text  image

6.Mark all boxes for the appropriate races.

The concept of race, as used by the Census Bureau, reflects self-identification by individuals according to the race or races with which they identify.

The instruction before question 5, "For this survey, Hispanic origins are not races" reflects the federal government's treatment of Hispanic origin and race as separate and distinct concepts. People who identify their origin as Hispanic, Latino, or Spanish may be of any race.

People may choose to provide two or more races either by marking two or more race response boxes, by providing multiple write-in responses, or by some combination of marking boxes and writing in responses.

If you mark the "American Indian or Alaska Native" box, also print the name of the tribe(s) in which the person is enrolled. If the person is not enrolled in a tribe, print the name of the principal tribe.

If you mark the "Other Asian" box, print the name of the specific race(s) or group(s) in the space provided. The category "Other Asian" includes persons who identify themselves as Laotian, Thai, Pakistani, Cambodian, Sri Lankan, and so on.

If you mark the "Other Pacific Islander" box, print the name of the specific race(s) or group(s) in the space provided. The category "Other Pacific Islander" includes persons who identify themselves as Fijian, Tongan, Polynesian, Tahitian and so on.

If you mark the "Some other race" box, print the race(s) or group(s) in the space provided.

This question should be answered by ALL persons.


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2010 ACS
Questionnaire form view entire document:  text  image

6. What is Person X's race? Mark (X) one or more boxes.

[ ] White
[ ] Black, African Am., or Negro
[ ] American Indian or Alaska Native -- Print name of enrolled or principal tribe. --> __________________
[ ] Asian Indian
[ ] Japanese
[ ] Chinese
[ ] Korean
[ ] Filipino
[ ] Vietnamese
[ ] Other Asian -- Print race, for example, Hmong, Laotian, Thai, Pakistani, Cambodian and so on.
[ ] Native Hawaiian
[ ] Guamanian or Chamorro
[ ] Samoan
[ ] Other Pacific Islander –Print race, for example, Fijian, Tongan, and so on.
[ ] Some other race -- Print race. -->
____________________________________________________
Questionnaire instructions view entire document:  text  image

6.Mark all boxes for the appropriate races.

The concept of race, as used by the Census Bureau, reflects self-identification by individuals according to the race or races with which they identify.

The instruction before question 5, "For this survey, Hispanic origins are not races" reflects the federal government's treatment of Hispanic origin and race as separate and distinct concepts. People who identify their origin as Hispanic, Latino, or Spanish may be of any race.

People may choose to provide two or more races either by marking two or more race response boxes, by providing multiple write-in responses, or by some combination of marking boxes and writing in responses.

If you mark the "American Indian or Alaska Native" box, also print the name of the tribe(s) in which the person is enrolled. If the person is not enrolled in a tribe, print the name of the principal tribe.

If you mark the "Other Asian" box, print the name of the specific race(s) or group(s) in the space provided. The category "Other Asian" includes persons who identify themselves as Laotian, Thai, Pakistani, Cambodian, Sri Lankan, and so on.

If you mark the "Other Pacific Islander" box, print the name of the specific race(s) or group(s) in the space provided. The category "Other Pacific Islander" includes persons who identify themselves as Fijian, Tongan, Polynesian, Tahitian and so on.

If you mark the "Some other race" box, print the race(s) or group(s) in the space provided.

This question should be answered by ALL persons.


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2009 ACS
Questionnaire form view entire document:  text  image

6. What is Person X's race? Mark (X) one or more boxes.

[ ] White
[ ] Black, African Am., or Negro
[ ] American Indian or Alaska Native -- Print name of enrolled or principal tribe. --> __________________
[ ] Asian Indian
[ ] Japanese
[ ] Chinese
[ ] Korean
[ ] Filipino
[ ] Vietnamese
[ ] Other Asian -- Print race, for example, Hmong, Laotian, Thai, Pakistani, Cambodian and so on.
[ ] Native Hawaiian
[ ] Guamanian or Chamorro
[ ] Samoan
[ ] Other Pacific Islander –Print race, for example, Fijian, Tongan, and so on.
[ ] Some other race -- Print race. -->
____________________________________________________
Questionnaire instructions view entire document:  text  image

6.Mark all boxes for the appropriate races.

The concept of race, as used by the Census Bureau, reflects self-identification by individuals according to the race or races with which they identify.

The instruction before question 5, "For this survey, Hispanic origins are not races" reflects the federal government's treatment of Hispanic origin and race as separate and distinct concepts. People who identify their origin as Hispanic, Latino, or Spanish may be of any race.

People may choose to provide two or more races either by marking two or more race response boxes, by providing multiple write-in responses, or by some combination of marking boxes and writing in responses.

If you mark the "American Indian or Alaska Native" box, also print the name of the tribe(s) in which the person is enrolled. If the person is not enrolled in a tribe, print the name of the principal tribe.

If you mark the "Other Asian" box, print the name of the specific race(s) or group(s) in the space provided. The category "Other Asian" includes persons who identify themselves as Laotian, Thai, Pakistani, Cambodian, Sri Lankan, and so on.

If you mark the "Other Pacific Islander" box, print the name of the specific race(s) or group(s) in the space provided. The category "Other Pacific Islander" includes persons who identify themselves as Fijian, Tongan, Polynesian, Tahitian and so on.

If you mark the "Some other race" box, print the race(s) or group(s) in the space provided.

This question should be answered by ALL persons.


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2008 ACS
Questionnaire form view entire document:  text  image

6. What is Person X's race? Mark (X) one or more boxes.

[ ] White
[ ] Black, African Am., or Negro
[ ] American Indian or Alaska Native -- Print name of enrolled or principal tribe. --> __________________
[ ] Asian Indian
[ ] Japanese
[ ] Chinese
[ ] Korean
[ ] Filipino
[ ] Vietnamese
[ ] Other Asian -- Print race, for example, Hmong, Laotian, Thai, Pakistani, Cambodian and so on.
[ ] Native Hawaiian
[ ] Guamanian or Chamorro
[ ] Samoan
[ ] Other Pacific Islander –Print race, for example, Fijian, Tongan, and so on.
[ ] Some other race -- Print race. -->
____________________________________________________
Questionnaire instructions view entire document:  text  image

6.

Mark one or more races.
If you mark the "American Indian or Alaska Native" box, also print the name of the tribe(s) in which the person is enrolled. If the person is not enrolled in a tribe, print the name of the principal tribe.
If you mark the "Other Asian" or the "Other Pacific Islander" box, print the name of the specific race(s) or group(s) in the space provided.
The category "Other Asian" includes persons who identify themselves as Laotian, Thai, Pakistani, Cambodian, and so on.
The category "Other Pacific Islander" includes persons who identify themselves as Fijian, Tongan, and so on.
If you mark the "Some other race" box, print the race(s) or group(s) in the space provided. This question should be answered by ALL persons.


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2007 ACS
Questionnaire form view entire document:  text  image

6. What is this person's race? Mark (X) one or more races to indicate what this person considers himself/herself to be

[ ] White
[ ] Black, African Am., or Negro
[ ] American Indian or Alaska Native -- Print name of enrolled or principal tribe --> ________________________________________
[ ] Asian Indian
[ ] Chinese
[ ] Filipino
[ ] Japanese
[ ] Korean
[ ] Vietnamese
[ ] Other Asian - Print race --> ____________________
[ ] Native Hawaiian
[ ] Guamanian or Chamorro
[ ] Samoan
[ ] Other Pacific Islander
[ ] Some other race - Print race below --> ____________________

Questionnaire instructions view entire document:  text  image

6.Mark one or more categories to indicate what each person considers himself or herself to be.

If you mark the "American Indian or Alaska Native" box, also print the name of the tribe(s) in which the person is enrolled. If the person is not enrolled in a tribe, print the name of the principal tribe.

If you mark the "Other Asian" or the "Other Pacific Islander" box, print the name of the specific race(s) or group(s) in the space provided.

The category Other Asian includes persons who identify themselves as Burmese, Hmong, Indonesian, Laotian, Pakistani, Thai, Cambodian, Sri Lankan, and so on.

The category Other Pacific Islander includes persons who identify themselves as Fijian, Tongan, Polynesian, Tahitian, and so on.

If you mark the "Some other race" box, print the race(s) or group(s) in the space provided.

This question should be answered for ALL persons, regardless of citizenship status.


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2006 ACS
Questionnaire form view entire document:  text  image

6. What is this person's race? Mark (X) one or more races to indicate what this person considers himself/herself to be

[ ] White
[ ] Black, African Am., or Negro
[ ] American Indian or Alaska Native -- Print name of enrolled or principal tribe --> ________________________________________
[ ] Asian Indian
[ ] Chinese
[ ] Filipino
[ ] Japanese
[ ] Korean
[ ] Vietnamese
[ ] Other Asian - Print race --> ____________________
[ ] Native Hawaiian
[ ] Guamanian or Chamorro
[ ] Samoan
[ ] Other Pacific Islander
[ ] Some other race - Print race below --> ____________________

Questionnaire instructions view entire document:  text  image

6.Mark one or more categories to indicate what each person considers himself or herself to be.

If you mark the "American Indian or Alaska Native" box, also print the name of the tribe(s) in which the person is enrolled. If the person is not enrolled in a tribe, print the name of the principal tribe.

If you mark the "Other Asian" or the "Other Pacific Islander" box, print the name of the specific race(s) or group(s) in the space provided.

The category Other Asian includes persons who identify themselves as Burmese, Hmong, Indonesian, Laotian, Pakistani, Thai, Cambodian, Sri Lankan, and so on.

The category Other Pacific Islander includes persons who identify themselves as Fijian, Tongan, Polynesian, Tahitian, and so on.

If you mark the "Some other race" box, print the race(s) or group(s) in the space provided.

This question should be answered for ALL persons, regardless of citizenship status.


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2005 ACS
Questionnaire form view entire document:  text  image

6. What is this person's race? Mark (X) one or more races to indicate what this person considers himself/herself to be

[ ] White
[ ] Black, African Am., or Negro
[ ] American Indian or Alaska Native -- Print name of enrolled or principal tribe --> ________________________________________
[ ] Asian Indian
[ ] Chinese
[ ] Filipino
[ ] Japanese
[ ] Korean
[ ] Vietnamese
[ ] Other Asian - Print race --> ____________________
[ ] Native Hawaiian
[ ] Guamanian or Chamorro
[ ] Samoan
[ ] Other Pacific Islander
[ ] Some other race - Print race below --> ____________________

Questionnaire instructions view entire document:  text  image

6.Mark one or more categories to indicate what each person considers himself or herself to be.

If you mark the "American Indian or Alaska Native" box, also print the name of the tribe(s) in which the person is enrolled. If the person is not enrolled in a tribe, print the name of the principal tribe.

If you mark the "Other Asian" or the "Other Pacific Islander" box, print the name of the specific race(s) or group(s) in the space provided.

The category Other Asian includes persons who identify themselves as Burmese, Hmong, Indonesian, Laotian, Pakistani, Thai, Cambodian, Sri Lankan, and so on.

The category Other Pacific Islander includes persons who identify themselves as Fijian, Tongan, Polynesian, Tahitian, and so on.

If you mark the "Some other race" box, print the race(s) or group(s) in the space provided.

This question should be answered for ALL persons, regardless of citizenship status.


top
2004 ACS
Questionnaire form view entire document:  text  image

6. What is this person's race? Mark (X) one or more races to indicate what this person considers himself/herself to be

[ ] White
[ ] Black, African Am., or Negro
[ ] American Indian or Alaska Native -- Print name of enrolled or principal tribe --> ________________________________________
[ ] Asian Indian
[ ] Chinese
[ ] Filipino
[ ] Japanese
[ ] Korean
[ ] Vietnamese
[ ] Other Asian - Print race --> ____________________
[ ] Native Hawaiian
[ ] Guamanian or Chamorro
[ ] Samoan
[ ] Other Pacific Islander
[ ] Some other race - Print race below --> ____________________

Questionnaire instructions view entire document:  text  image

6.Mark one or more categories to indicate what each person considers himself or herself to be.

If you mark the "American Indian or Alaska Native" box, also print the name of the tribe(s) in which the person is enrolled. If the person is not enrolled in a tribe, print the name of the principal tribe.

If you mark the "Other Asian" or the "Other Pacific Islander" box, print the name of the specific race(s) or group(s) in the space provided.

The category Other Asian includes persons who identify themselves as Burmese, Hmong, Indonesian, Laotian, Pakistani, Thai, Cambodian, Sri Lankan, and so on.

The category Other Pacific Islander includes persons who identify themselves as Fijian, Tongan, Polynesian, Tahitian, and so on.

If you mark the "Some other race" box, print the race(s) or group(s) in the space provided.

This question should be answered for ALL persons, regardless of citizenship status.


top
2003 ACS
Questionnaire form view entire document:  text  image

6. What is this person's race? Mark (X) one or more races to indicate what this person considers himself/herself to be

[ ] White
[ ] Black, African Am., or Negro
[ ] American Indian or Alaska Native -- Print name of enrolled or principal tribe --> ________________________________________
[ ] Asian Indian
[ ] Chinese
[ ] Filipino
[ ] Japanese
[ ] Korean
[ ] Vietnamese
[ ] Other Asian - Print race --> ____________________
[ ] Native Hawaiian
[ ] Guamanian or Chamorro
[ ] Samoan
[ ] Other Pacific Islander
[ ] Some other race - Print race below --> ____________________

Questionnaire instructions view entire document:  text  image

6.Mark one or more categories to indicate what each person considers himself or herself to be.

If you mark the "American Indian or Alaska Native" box, also print the name of the tribe(s) in which the person is enrolled. If the person is not enrolled in a tribe, print the name of the principal tribe.

If you mark the "Other Asian" or the "Other Pacific Islander" box, print the name of the specific race(s) or group(s) in the space provided.

The category Other Asian includes persons who identify themselves as Burmese, Hmong, Indonesian, Laotian, Pakistani, Thai, Cambodian, Sri Lankan, and so on.

The category Other Pacific Islander includes persons who identify themselves as Fijian, Tongan, Polynesian, Tahitian, and so on.

If you mark the "Some other race" box, print the race(s) or group(s) in the space provided.

This question should be answered for ALL persons, regardless of citizenship status.


top
2002 ACS
Questionnaire form view entire document:  text  image

6. What is this person's race? Mark (X) one or more races to indicate what this person considers himself/herself to be

[ ] White
[ ] Black, African Am., or Negro
[ ] American Indian or Alaska Native -- Print name of enrolled or principal tribe --> ________________________________________
[ ] Asian Indian
[ ] Chinese
[ ] Filipino
[ ] Japanese
[ ] Korean
[ ] Vietnamese
[ ] Other Asian - Print race --> ____________________
[ ] Native Hawaiian
[ ] Guamanian or Chamorro
[ ] Samoan
[ ] Other Pacific Islander
[ ] Some other race - Print race below --> ____________________
Questionnaire instructions view entire document:  text  image

6.Mark one or more categories to indicate what each person considers himself or herself to be.

If you mark the "American Indian or Alaska Native" box, also print the name of the tribe(s) in which the person is enrolled. If the person is not enrolled in a tribe, print the name of the principal tribe.

If you mark the "Other Asian" or the "Other Pacific Islander" box, print the name of the specific race(s) or group(s) in the space provided.

The category Other Asian includes persons who identify themselves as Burmese, Hmong, Indonesian, Laotian, Pakistani, Thai, Cambodian, Sri Lankan, and so on.

The category Other Pacific Islander includes persons who identify themselves as Fijian, Tongan, Polynesian, Tahitian, and so on.

If you mark the "Some other race" box, print the race(s) or group(s) in the space provided.

This question should be answered for ALL persons, regardless of citizenship status.


top
2001 ACS
Questionnaire form view entire document:  text  image

6. What is this person's race? Mark (X) one or more races to indicate what this person considers himself/herself to be

[ ] White
[ ] Black, African Am., or Negro
[ ] American Indian or Alaska Native -- Print name of enrolled or principal tribe --> ________________________________________
[ ] Asian Indian
[ ] Chinese
[ ] Filipino
[ ] Japanese
[ ] Korean
[ ] Vietnamese
[ ] Other Asian - Print race --> ____________________
[ ] Native Hawaiian
[ ] Guamanian or Chamorro
[ ] Samoan
[ ] Other Pacific Islander
[ ] Some other race - Print race below --> ____________________
Questionnaire instructions view entire document:  text  image

6.Mark one or more categories to indicate what each person considers himself or herself to be.

If you mark the "American Indian or Alaska Native" box, also print the name of the tribe(s) in which the person is enrolled. If the person is not enrolled in a tribe, print the name of the principal tribe.

If you mark the "Other Asian" or the "Other Pacific Islander" box, print the name of the specific race(s) or group(s) in the space provided.

The category Other Asian includes persons who identify themselves as Burmese, Hmong, Indonesian, Laotian, Pakistani, Thai, Cambodian, Sri Lankan, and so on.

The category Other Pacific Islander includes persons who identify themselves as Fijian, Tongan, Polynesian, Tahitian, and so on.

If you mark the "Some other race" box, print the race(s) or group(s) in the space provided.

This question should be answered for ALL persons, regardless of citizenship status.


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2000 5%
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6. What is this person's race?
Mark [X] one or more races to indicate what this person considers himself/herself to be.
[] White
[] Black, African Am., or Negro
[] American Indian or Alaska Native - Print name of enrolled or principal tribe.
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[] Asian Indian
[] Chinese
[] Filipino
[] Japanese
[] Korean
[] Vietnamese
[] Other Asian - Print race.
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[] Native Hawaiian
[] Guamanian or Chamorro
[] Samoan
[] Other Pacific Islander - Print race.
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[] Some other race - Print race.
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