Excell Academy's Ethnic and Racial Designation Form

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Schools are required to report ethnicity and race to the state and to the U.S. Department of Education. Because of recent changes to Minnesota state law, Minnesota disaggregates each category into detailed groups to further represent our student populations. Parents or guardians are not required to answer the federal questions for their children. If you choose not to answer the federal questions, federal law requires schools to choose for you. This is a last resort—we prefer if parents or guardians complete the form. State questions are labeled as “Optional” and schools will not fill in this information for you. This information helps improve teaching and learning for everyone and helps us accurately identify and advocate for students currently underserved. The information this form collects is considered private information. You can review the privacy notice to learn more about the purpose of collecting this information, how it will be used and not used, and how the detailed groups were identified. The privacy notice can be found in our Frequently Asked Questions: Ethnic and Racial Designation Form: https://education.mn.gov/MDE/fam/count/

Student First Name *

Middle Name/Initial

Student Last Name *

Date of Birth *

YYYY

Is the student Hispanic/Latino as defined by the federal government? *

The federal definition includes person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race. You must select yes or no to this question.

Yes

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