St. Croix Central School District Census Data
The district must gather information for all residents under the age of 21, regardless of whether or not they attend St. Croix Central Schools. If you are new to the district OR have had any changes in your family's status in the past year, please complete this form. It is especially important to have information about children ages 0-5 in order to send mailings regarding 4K and kindergarten registrations and events. An accurate count of future students is also necessary in planning for district needs. If you have any questions, please call or email Lacy Leckey 715-749-3119 / lleckey@scc.k12.wi.us. Thank you!
**PLEASE NOTE: THIS FORM SHOULD ONLY BE COMPLETED IF YOU HAVE CHILDREN WHO ARE NOT CURRENTLY ATTENDING AN SCC SCHOOL**
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Email *
Today's Date *
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Child's Full Name (First, Middle, Last) *
Child's Date of Birth *
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Child's Gender *
Child's Place of Birth (City, County, State, Country) *
Child's Race *
Custodial Parent/Guardian Name #1  (First, Last) *
Custodial Parent/Guardian Name #2 (First, Last)
Home Address *
Phone Number *
Child #2's Full Name (First, Middle, Last)
**TO BE COMPLETED ONLY IF YOU HAVE AN ADDITIONAL CHILD TO ADD
Child #2's Date of Birth
**TO BE COMPLETED ONLY IF YOU HAVE AN ADDITIONAL CHILD TO ADD
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DD
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YYYY
Child #2's Gender
**TO BE COMPLETED ONLY IF YOU HAVE AN ADDITIONAL CHILD TO ADD
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Child #2's Place of Birth (City, County, State, Country)
**TO BE COMPLETED ONLY IF YOU HAVE AN ADDITIONAL CHILD TO ADD
Child #2's Race
**TO BE COMPLETED ONLY IF YOU HAVE AN ADDITIONAL CHILD TO ADD
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Child #3's Full Name (First, Middle, Last)
**TO BE COMPLETED ONLY IF YOU HAVE AN ADDITIONAL CHILD TO ADD
Child #3's Date of Birth
**TO BE COMPLETED ONLY IF YOU HAVE AN ADDITIONAL CHILD TO ADD
MM
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DD
/
YYYY
Child #3's Gender
**TO BE COMPLETED ONLY IF YOU HAVE AN ADDITIONAL CHILD TO ADD
Clear selection
Child #3's Place of Birth (City, County, State, Country)
**TO BE COMPLETED ONLY IF YOU HAVE AN ADDITIONAL CHILD TO ADD
Child #3's Race
**TO BE COMPLETED ONLY IF YOU HAVE AN ADDITIONAL CHILD TO ADD
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