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I am an EXISTING Celerion participant

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(Social Security Number, National Insurance Number, Individual Taxpayer Identification Number)
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I am a NEW Celerion participant

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(Social Security Number, National Insurance Number, Individual Taxpayer Identification Number)
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Personal Information
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Preferences and General Questions
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Hispanic or Latino
A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race.
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.
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.
Asian
A person having origins in any of the original peoples of the Far East, Southern Asia or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand and Vietnam.