In keeping with our value of promoting racial, ethnic, and gender diversity, The Kresge Foundation is committed to gathering demographic data concerning grantseekers and the populations they serve. We ask that you provide the information requested on this form to the best of your ability. Definitions are provided on page 2. We welcome your feedback on the usability of the form. If you would like to offer comments, please email with your thoughts.
Name of organization:
Name of person completing this form: / Today’s Date:
Governing Board: / Number of board members (actual count):
Gender: / Race:
% / Female / / % / American Indian or Alaska Native
% / Male / % / Asian
% / Black or African American
Total must equal 100% / % / Native Hawaiian or Other Pacific Islander
% / White
% / More than one race
Ethnicity:
% / Hispanic or Latino / Total must equal 100%
% / Not Hispanic or Latino
Total must equal 100%
Staff Members: (full and part-time paid employees) / Number of staff members (actual count):
Gender: / Race
% / Female / % / American Indian or Alaska Native
% / Male / % / Asian
% / Black or African American
Total must equal 100% / % / Native Hawaiian or Other Pacific Islander
% / White
% / More than one race
Ethnicity:
% / Hispanic or Latino / Total must equal 100%
% / Not Hispanic or Latino
Total must equal 100%
Population Served: (if applicable) / Number of population served (unduplicated):
Gender: / Race:
% / Female / % / American Indian or Alaska Native
% / Male / % / Asian
% / Black or African American
Total must equal 100% / % / Native Hawaiian or Other Pacific Islander
% / White
% / More than one race
Ethnicity:
% / Hispanic or Latino / Total must equal 100%
% / Not Hispanic or Latino
Total must equal 100%
If explanation is necessary, please use the space provided.
Note: The federal Office of Management and Budget employs the following definitions of ethnic and racial categories.
Ethnic Categories
Hispanic or Latino: A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race.
Racial Categories
American Indian or Alaska Native: A person having origins in any of the original peoples of North and South America (including Central America), and who maintains tribal affiliation or community attachment.
Asian: A person having origins 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.
Black or African American:A person having origins in any of the black racial groups of Africa.
Native Hawaiian or Other Pacific Islander: A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.
White: A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.
6/09