Title I - Duval County Public Schools 2018-2019
Your child's school is trying to qualify for extra services for their students. Please help by following the directions below to complete this form. All information is kept confidential and is only used to determine funding for the entire school, not individual students.

Please see the letter written by our Principal, Deacon David Yazidya, about this survey by clicking the link below:

Email address *
Your family's home address (include city, state): *
Your answer
Your family's zip code: *
Your answer
Name of Private School: *
Your answer
Grade levels of all children living in your household and attending this school between 9 - 12 grade: *
Your answer
What is your family size? (number of people that live in your home)
1. Is your monthly income equal to or less than the amount listed below in the "income earned each month" column? *
2. Does your family qualify for food stamps? *
3. Are you receiving Temporary Assistance to Needy Families (TANF)? (Formerly Aid to Families with Dependent Children or Public Assistance) *
Thank you for your assistance.
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