Change in Race/Ethnicity

Name Name First Last
CMC ID Number:
Student Campus Email

e.g. Tstudent22@students.cmc.edu
Are you a US Citizen?

Are you a US Citizen? Yes No
Visa Type/Residency Status:
Are you Hispanic or Latino?

Are you Hispanic or Latino? Yes No
Select one or more of the following races:

Select one or more of the following races: American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander White