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[]
[{"$nulls":13},"AFFACT 08-3"]
[{"$nulls":13},"2014-10-01"]
["Observer-Collected Contacts Log"]
["This form is to document demographic information of program participants when circumstances do not allow for self-reporting by clientele."]
[]
["Program Event:",{"$nulls":7},"Date:"]
[null,"Location:",{"$nulls":6},"Conducted by:"]
[]
[]
[]
[{"$nulls":4},"Race or Ethnicity"]
[null,null,"Gender",null,"American Indian/           Alaskan Native","Asian","Black/                   African American","Hispanic or Latino","Native Hawaiian/                 Pacific Islander","White"]
[null,null,"Female"]
[null,null,"Male"]
[]
[]
[]
[null,"American Indian or Alaskan Native:  A person having origins in any of the orignal peoples of North America, and maintains cultural identification through tribal affilications or community recognition"]
[null,"Asian:  A person having origin in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent, including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam. "]
[]
[null,"Black or African American:  A person having origins in any of the black racial groups of Africa."]
[]
[null,"Hispanic or Latino:  A person of Mexico, Puerto Rican, Cuban, Central or South America, or other Spanish Culture or origin, regardless of race."]
[]
[null,"Native Hawaiian:  A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands. "]
[]
[null,"White:  - A person having origins in any of the original people of Europe, North Africa, or the Middle East. "]