The form - created by the U.S. Census Bureau and approved by Congress more than a year ago - allows people to identify themselves as "negro" during the government's decennial population count for the United States, WCBS-TV reports.
Respondents for the form can check a box identifying themselves as "negro," "African American" and "black." All three terms appear next to the same box.
"The fact that it's 2010 and they're still putting 'negro,' I am a little offended," Secaucus, N.J., resident Dawud Ingram told WCBS-TV. "African Americans haven't been going by the term 'negro' for decades now. It's really confusing."
Census officials told WCBS-TV that the term was added to this decade's form after some respondents - primarily older blacks - wrote "negro" on the form in 2000.
But Chanou Wilshire told WCBS-TV she found the inability to choose one term over another to be "highly offensive."
The bureau, which operates under the Commerce Department, is considering whether to remove the term for the next census in 2020.