Margaret (Peggy) Benuar
if\A ANA I E 6k,4:
DIVERSITY STATISTICS REPORTING
Name: 1\1 1 6-\cfe 66i) P.-•-4 04.
Board,/ Committee: V. G . A
{ fYJ)f/f t
Appointment Date. Jf
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 Female 71 )6
Race/Ethnic Categories
What is your race?
La African-American/Black •
OCaucasian/White
I Asian or Pacific Islander
Native-American/American Indian
La Other— Print Race:
Do you consider yourseeik o be Spanish, Hispanic or Latino/a? Mark the "No"box if not
Spanish, Hispanic, Latino_/a;
1No ¢ °, •
Yes
Do you consider yourself Physically Disabled?
La 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