Many Dental Schools may want to know information about your ethnicity and race. Check all that apply.
Do you consider yourself to be of Hispanic origin? Hispanic/Latino/Latina
Please check all that apply below:
Cuban
Mexican, Mexican American, Chicano/Chicana
Puerto Rican
South or Central American
Other Spanish culture or origin
If other, please specify:
No, not Hispanic/Latino/Latina
Race
Which of the following best describe your race? Please mark one or more races. American Indian or Alaska Native
Please specify the name of your enrolled or principal tribe:
Asian
Please check all that apply below:
Asian Indian
Cambodian
Chinese
Filipino
Japanese
Korean
Malaysian
Pakistani
Vietnamese
Other Asian
If other, please specify:
Black or African-American
Native Hawaiian or Other Pacific Islander
Please check all that apply below:
Guamanian or Chamorro
Native Hawaiian
Samoan
Other Pacific Islander
If other, please specify:
White