LGUMHS Resource Form

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Please help us maintain equality of opportunity by answering the following questions. All information will be kept confidential. While this information is not required for your student to attend school, it is required for your child to be eligible to qualify for certain free resources (coats, shoes, boots, mittens, etc.) as well as scholarships when they are approaching graduation.

Guardian's Full Name(s) *

Child(ren)'s Full Name(s) *

How many adults (18+ years old) live in your household? *

How many children (under 18 years old) live in your household? *

What is your total household annual income? *

$0 - $30,000

$30,001 - $60,000

$60,001 - $90,000

$90,001 - $120,000

$120,001+

Please indicate the highest level of education achieved by each guardian in your household. This information will help us determine if your student is eligible for certain scholarships along with other benefits. *

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