2019-2020 Racial and Ethnic Identification
Good Shepherd Lutheran Preschool admits students of any race, color, national and ethnic origin to all the rights, privileges, programs and activities generally accorded or made available to students at the school. It does not discriminate on the basis of race, color, or national and ethnic origin in administration of its educational policies, admissions policies, scholarship and loan programs, and athletic and other school-administered programs.

In accordance with regulations pertaining to Private School Certification, Good Shepherd Lutheran Preschool is required to solicit information regarding the racial composition of its student population. Your furnishing this information is voluntary. Your failure to do so will have no effect on your child’s tenure in the preschool. If you fail to provide the information, however, Good Shepherd Lutheran Preschool will attempt to identify your child’s racial category by visual perception.

Thank you for your cooperation.

Email address *
Child's First Name *
Your answer
Child's Last Name *
Your answer
Child's 2019-2020 Class *
Families with Multiple Students
If you are submitting forms for multiple students from the same family, you may list the names and classes of other students below if the information on this form is the same for all students in the family. You do not need to submit this form again for the students listed below.
Your answer
Racial and Ethnic Identification
Hispanic Ethnicity
Is your child of Hispanic, Latino, or Spanish origin?
Racial Identification
Please indicate your child’s racial identification by marking one or more of the following categories from the 2010 US Census:
Electronic Signature *
Type your full name below to sign this form.
Your answer
Today's Date *
A copy of your responses will be emailed to the address you provided.
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