Richard Awdeh INA AM F 11-4
DIVERSITY STATISTICS REPORTING
Name:
4-(,0 octILI-1
n
Board / Committee: (14 ;:.� '-'t, A d t s O ,t,1 f`;,�, ; �
Appointment Date: I \
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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 Female
' Race/Ethnic Categories
• What is your race?
,African-American/Black
Caucasian/White
L1 Asian or Pacific Islander
Native-American/American Indian •
L1 Other— Print Race:
Do you consider yourself to be Spanish, Hispanic or Latino/a? Mark-the "No"box if not
Spanish, Hispanic, Latino/a: t -- '.�' N'
�
LD Yes _. co
Do you consider yourself Physically Disabled? :
VNo ,
• A�Yes co.)fir¢
•
•
•
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