Gabriel Paez is\AIANA BEACH•
DIVERSITY STATISTICS REPORTING
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Name: 0 +4; f/ L
Board / Committee: fr'e(
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Appointment Date: 2 7 /
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Pursuant to City of Miami Beach 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 LD Female Ul
Race/Ethnic Categories
What is your race?
Africarri=American/Black
- ucasian%White ,"
Asian or Pacific Islander
Native-American/American Indian
EJ Other— Print Race: -
Do you consider yourself to be Spanish, Hispanic or Latino/a? Mark"the' "No"box if not
Spanish, Hispanic, Latino/a
-
No
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ou consider yourself Physically Disabled?
Do you � y Y Y
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El 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