People Present Form
White not of Hispanic
Origin
Adult
Youth
Black not of Hispanic
Origin
Adult
Youth
American Indian or
Alaskan Native
Adult
Youth
Hispanic or
Latino
Adult
Youth
Asian or
Pacific Islander
Adult
Youth
Male
Female
TOTAL
This form is to be given to the teacher before the reading begins.
While the volunteer is reading, as a courtesy, we ask that you record the above information for all
people present during the reading. This includes you, the volunteer, any additional adults, and all of
the students.
As a federal program, we are required to obtain the above information for statistical purposes. For
some people, race and/ethnicity can be a sensitive topic, especially when the provided categories do
not apply to all people. Furthermore, one cannot always accurately identify one’s race/ethnicity
simply by looking at physical characteristics.
Although we acknowledge the limitations of the above method, we appreciate your assistance in
providing the data. Your best guess in providing the data will be sufficient. Most importantly make
sure that the total numbers correspond to the total number of present. Thank you!