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.
Email address *
Child's Full Legal Name (First, Middle, Last) *
Your answer
Date of Birth (Month, Day, Year) *
(Note: Make sure to enter the correct year; Example: January 14, 2014)
Your answer
Gender *
Mark only one.
Race (choose one or more) *
Check all that apply.
Required
Language *
Mark only one.
Is your child Hispanic of Latino? *
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 *
Your answer
Physical Residence Address (house #, street name, city, state, zip) *
Your answer
Mailing Address (including city, state, zip) *
Your answer
Home Language (language used by parents) *
Mark only one.
Parent/Guardian #1 Legal Name (First, MI, Last) *
Your answer
Parent/Guardian #1 Relationship to Child *
Mark only one.
Parent/Guardian #1 Cell Phone
Your answer
Parent/Guardian #1 Work Phone
Your answer
Parent/Guardian #2 Legal Name (First, MI, Last)
If living in same residence as P/G #1
Your answer
Parent/Guardian #2 (P/G2) Relationship to Child
Mark only one.
Parent/Guardian #2 Cell Phone
Your answer
Parent/Guardian #2 Work Phone
Your answer
Parent/Guardian #2 E-mail Address
Your answer
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
Your answer
Physical Residence Address (House #, street name, city, state, zip)
Your answer
Mailing Address (including city, state, and zip)
Your answer
Home Language (language use by parents)
Mark only one.
Parent/Guardian #1 Legal Name (First, MI, Last)
Your answer
Parent/Guardian #1 Relationship to Child
Mark only one
Parent/Guardian #1 Cell Phone
Your answer
Parent/Guardian #1 Work Phone
Your answer
Parent/Guardian #1 E-mail Address
Your answer
Parent/Guardian #2 Legal Name (First, MI, Last)
Your answer
Parent/Guardian #2 Relationship to Child
Mark only one.
Parent/Guardian #2 Cell Phone
Your answer
Parent/Guardian #2 Work Phone
Your answer
Parent/Guardian #2 E-mail Address
Your answer
Submit
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