Student Census and Enrollment Information Form General InformationEmail* Enter Email Confirm Email Email address of the person filling out the form (so we can respond to you if necessary)Form InformationName* First Last Grade Entering*12345678Gender* Male Female Birthdate* MM slash DD slash YYYY Residences* Homeless Living with Relative / Friends Ethnicity (Race)Please select all that apply* American Indian or Alaskan Native Asian or Pacific Islander Black (not of Hispanic origin) Hispanic White (not of Hispanic origin) Home LanguageIs a language other than English spoken in the home?* Yes No If yes, what language is spoken in your home? What date did you first attend a United States school? MM slash DD slash YYYY Parent / Guardian Signature*Date* MM slash DD slash YYYY CAPTCHANameThis field is for validation purposes and should be left unchanged. Δ