Birth to 4-Year-Old Child Census
Please complete this form for any child that lives within the School District of Turtle Lake boundaries that is 4-years old or younger and not yet attending school in the School District of Turtle Lake.  This information allows us to include you in our future mailings for Child Development Days in April and for 4K enrollment.  This census will be open until April 30.  Thank you for your cooperation in advance!
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Email *
Child's Full Legal Name (First, Middle, Last) *
Date of Birth (Month, Day, Year) *
(Note: Make sure to enter the correct year; Example: January 14, 2014)
Gender *
Mark only one.
Race (choose one or more) *
Check all that apply.
Required
Language *
Mark only one.
Is your child Hispanic of Latino? *
Do you have concerns about your child's development before they begin school? *
Please check all concerns, if any, below. *
Required
Would you like the Turtle Lake School District to contact you with these concerns to set up screenings or assistance? *
First Family Information
Only one family of a 50/50 custody situation should be listed here and the other should be listed in Second Family info.
Primary Phone Number *
Physical Residence Address (house #, street name, city, state, zip) *
Mailing Address (including city, state, zip) *
Home Language (language used by parents) *
Mark only one.
Parent/Guardian #1 Legal Name (First, MI, Last) *
Parent/Guardian #1 Relationship to Child *
Mark only one.
Parent/Guardian #1 Cell Phone
Parent/Guardian #1 Work Phone
Parent/Guardian #2 Legal Name (First, MI, Last)
If living in same residence as P/G #1
Parent/Guardian #2 (P/G2) Relationship to Child
Mark only one.
Clear selection
Parent/Guardian #2 Cell Phone
Parent/Guardian #2 Work Phone
Parent/Guardian #2 E-mail Address
Second Family Information
Complete this section only if the student has a 2nd family with an address different than the first family; such as in a shared custody situation.
Primary Phone Number
Physical Residence Address (House #, street name, city, state, zip)
Mailing Address (including city, state, and zip)
Home Language (language use by parents)
Mark only one.
Clear selection
Parent/Guardian #1 Legal Name (First, MI, Last)
Parent/Guardian #1 Relationship to Child
Mark only one
Clear selection
Parent/Guardian #1 Cell Phone
Parent/Guardian #1 Work Phone
Parent/Guardian #1 E-mail Address
Parent/Guardian #2 Legal Name (First, MI, Last)
Parent/Guardian #2 Relationship to Child
Mark only one.
Clear selection
Parent/Guardian #2 Cell Phone
Parent/Guardian #2 Work Phone
Parent/Guardian #2 E-mail Address
Submit
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