Form Reg - Business Registration Demographic Information - City Of Portland

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BUSINESS REGISTRATION
DEMOGRAPHIC INFORMATION
The following information is being requested in conjunction with the City of Portland Business License
registration form. You are not required to furnish the information, but are encouraged to do so.
BUSINESS NAME (optional) (as reported on page 1 of the registration form):
RACE/ETHNICITY (Select all that apply):
Hispanic or Latino
Other
American Indian or Alaska Native
Native Hawaiian or Other Pacific Islander
Publicly held or other firm not classifiable by race/ethnicity
Asian
White
Black or African American
I otherwise do not wish to furnish this information
GENDER IDENTITY (Select one):
Woman
Man
Another identity
Publicly held or other firm not classifiable by gender
I otherwise do not wish to furnish this information
FORM REG (Rev 4/26/2017)

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