Megan Riley •
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DIVERSITY STATISTICS REPORTING
Name: :� }
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Board / Committee: .'
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Appointment Date: (;1 i 1 1 5
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: .
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Gender: Male Zji Female .
•
Race/Ethnic Categories
What is your race? ::.
/African-American/Black
Caucasian/White .
LI Asian or Pacific Islander
- La Native-American/American Indian :, t
Other Print Race: , - ' ,�° : - t = '
Do you consider yourself to be Spanish, Hispanic or Latino/a? Mark the "No”box if not
Spanish, Hispanic, Latino/a. ,-,
.N'o (, =.- - 4--r te' _ : !:,,.. -,,:' ,-- _,7 r,
Yes L.; - ' ' . , // . - ; •
Do you consider yourself Physics ly Disabled? �,..
S - .
fv(, No
• U Yes . , .
.
C:\Users\CENTFraN\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\NP4J9CNX\BC minority
information form 05-20-13"FINAL.docr ' 4 t ' f
Updated: Monday,January 26,2015