Lapwai School District Literacy Funding Survey:

Your assistance with the following financial information will support increased state literacy funding for Lapwai Elementary students in grades kindergarten through 3rd grade. The information will be handled with the strictest of confidentiality. Thank you for your support in ensuring our primary students receive the highest funding possible to support their growth in reading. Please contact David Aiken, Lapwai School District Superintendent, with questions at (208) 843-2622;

PRIVACY ACT STATEMENT: This explains how we will use the information you give us. Various federal programs require the information on this form. You do not have to provide the information, but if you do not, LEAs may not be eligible for amounts of federal funding calculated using the data. This form uses your eligibility information to help your Charter LEAs, Private Schools, or other LEAs evaluate, fund, or determine benefits for their Federal and some other programs. All information is highly confidential and must be handled accordingly by all program officers.
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Family Name/Parent Guardian Name(s):
Number of children attending Lapwai School District:
Number of people living in your household:
Please list the names of all of your children currently enrolled in Kindergarten, 1st, 2nd or 3rd grade.
Please refer to this chart when answering the next question:
Is your family or foster child’s yearly, monthly or weekly income equal to or less than the amount on the income eligibility chart above?
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What is your full physical address? House Number, Street, City, State, Zip Code:
I certify that all of the information provided is true and correct.  I understand that this information is being given for the receipt of federal funds. Please type your name and the date as your digital signature (Please include both your name and the date):
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