Please provide the following information for your membership record.
This information will not be used in any way other than calculating minority status within the organization.
This information will be considered private and not given or sold to any organizations outside of NEA.
The 10 digit ID is the all numeric number located on your mailing label from the letter sent to you
requesting your ethnicity identification.
First Name *
Last Name *
10 Digit ID # *
Local Association *
Ethnicity Type *
American Indian/Alaska Native
Caucasian (not Hispanic Origin)
Native Hawaiian/Pacific Islander
Other (Please describe below)
If these categories do not
describe your ethnicity,
please describe it here.
* = Input is required
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