St. Francis Area Schools

Family Census Record Form

Please fill out the form completely and help us maintain accurate information by notifying us of change of address and additions/subtractions to your household. Questions? Call 763-753-7049.

RESIDENT & DWELLING INFORMATION


HEAD OF HOUSEHOLD (HH1) ADULT #1

First, Middle, Last​​
If different from above​​

HEAD OF HOUSEHOLD (HH2) ADULT #2

First, Middle, Last​
If different from above​

FAMILY INFORMATION
List all people living at the residence, including all children (babies, toddlers, preschoolers, school age) and adults. If you have more than 6 family members living in your household, please contact Kara Merrifield at 763-753-7049.

PERSON 1

First, Middle, Last​

PERSON 2

First, Middle, Last​

PERSON 3

First, Middle, Last​

PERSON 4

First, Middle, Last​

PERSON 5

First, Middle, Last​

PERSON 6

First, Middle, Last​

Check here if a member of the household is expecting a baby.​​​

If the box is checked, please supply household member name. You may be contacted by the St. Francis Area Schools Early Childhood Family Center.

Sign by typing in your primary phone.​​

Please provide an email address where we can send a link to your current form.

Email Address :