Little Axe Schools Impact Aid Program Survey 9/18/2023
Enter information in this section regarding the parent/guardian if 
1)  either parent/guardian whom the student resided was on active duty in the Uniformed Services of the United States and 
2) wither parent/guardian with whom the student resided was employed on federal property, or 
3) either the parent/guardian reported to work on federal property on the survey date.  

Enter the parent/guardian's name as it appears on the employer's payroll record.  
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Email *
Parent/Guardian's Last Name *
Parent/Guardian's First Name and middle initial
 *
List the names of all the Little Axe students whose parents/guardians are filling out this form.  
First and Last Name, DOB, and Grade (new line for each)
 *
If you live on federal land, name the federal property which you live on.  
Do you work on Federal Land?   *
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