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j, <br /> r <br /> I <br /> Implementation <br /> o Forms will be completed prior to NCDOT Title VI reviews and remain on file for three years . <br /> o All new and existing members of appointed decision - making boards or committees will be <br /> required to complete this form for reporting purposes . <br /> I <br /> o If a member, for whatever reason , selects "I choose not to provide any of the information <br /> requested above, " this will be accepted as a completed form . <br /> o If a member chooses not to provide any of the information on the form , the Title VI Coordinator <br /> will be permitted to indicate that member' s race and gender, based on the Coordinator' s best <br /> guess . <br /> o Data from these forms will be used to complete the Demographic Request Table . <br /> o Once a new member submits this form , the Demographic Request Table for the associated <br /> committee will be updated . <br /> i <br /> c <br /> I <br /> I <br /> is <br /> f: <br /> i <br /> i <br /> I' <br /> I <br /> C <br /> t <br />