Aaron Perry /MIAMI BEACH
•
DIVERSITY STATISTICS REPORTING
Name: a ,r t" �� r
•
Board / Committee: �' Uri ``�J�U ��� 1" (c- Y L.�
Appointment Date: / .= I' 1*5
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Pursuant to City of Miami Beal Ordinance 2009-3632, the City is required to annually
prepare and present a report to the City. Commission identifying the City's diversity
statistics. This form allows board and committee applicants and members to voluntarily
self-identify their race, ethnicity, disabled status and gender.
Please check the appropriate box for each category:
Gender: Male
1' maIe
Race/Ethnic Categories
What is your race?
African-American/Black
Caucasian/White
Asian or Pacific Islander
Native-American/American Indian
Other— Print Race:
Do you consider yourself to beeSpanish, Hispanic or Latino/a? Mark the ``IIo'box`if not
Spanish, Hispanic, Latino/a.
No
Zi Yes
Do you consider yourself Physically Disabled?
No
Yes.
C:\Users\CENTFraN\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\NP4J9CNX\BC minority
information form 05-20-13 FINAL.doc
Updated: Monday,January 26,2015