Ethnicity Form

Spark Charter School

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Ethnicity Data Collection

Spark is REQUIRED to collect this data per the Santa Clara County Office of Education and the California Dept. of Education

Please complete a form for EACH student you have enrolled at Spark

* Indicates required field

Student Name *

First

Last

Is student Hispanic/Latino? *

Yes No

Please check all that apply *

African American or Black American Indian/Alaskan Native Asian* Pacific Islander** White

*If Asian is checked above, please select all subgroups that apply *

Chinese Japanese Filipino Korean Vietnamese Asian Indian Laotian Cambodia Other

**If Pacific Islander is checked above, please select all subgroups that apply *

Hawaiian Guamanian Samoan Other

Submit

Spark Charter School PO BOX 60416, Sunnyvale, CA 94088 info@SparkCharter.org / 209-806-3045