Eric Montes de Oca Minority Report „It
M1AM I E
DIVERSITY STATISTICS REPORTING
Name: Ei 1 v 625 E 0Q4 •
Board / Committee: ► Q
214.3rott- u4l Pa, re`�i�► 6/C � �% - / casf�,��
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Appointment Date: 3 /4--
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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 Zemale
Race/Ethnic Categories '
What is your race?
• �African-American/Black •
, \\
4� Caucasian/White •
Asian or.Pacific Islander
La Native-American/American Indian
La Other- Print Race:
Do you consider yourself to be Spanish, Hispanic or Latino/a? Mark the "No”box if not
Spanish, Hispanic, Latino/a.
Ud Yes
Do you consider yourself Physically Disabled?
O No .
E Yes
•
C:\Use•s\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
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