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2024 FIYRS Family Registration
This survey will support the FFSC to provide the resources and make connections between stakeholders to serve FIYRS families.
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* Indicates required question
Family Demographic Information
Parent/ Guardian First Name
*
Your answer
Parent/Guardian Last Name
*
Your answer
Email Address
*
Your answer
Phone Number
*
Your answer
Address
*
Your answer
Zip Code
*
Your answer
Race/Ethnicity
*
Black/ African American
Latino / Hispanic
White/ Caucasian
Native American
Asian
Middle Eastern
Other
Prefer not to say
Required
How many adults (18+) currently live in your household?
*
Choose
1
2
3
4
5+
How many children (under 18) currently live in your household?
*
Choose
1
2
3
4
5+
Child(ren) Grade Level(s)
*
Based on the current school year or the last grade level completed.
K-2
3-5
4-6
9-12
Required
What is your annual household income? (Please select from the list below):
*
This would be total of all individual incomes in the household.
Choose
$0 - 20,000
$20,001 - 25,000
$25,001 - 30,000
$30,001 - $35,000
$35,001 - 40,000
40,001 - 50,000
$50,001 - 55,000
$55,001 - 60,000
$60,001 - 65,000
$65,001 - 70,000
$75,001 - 80,000
$80,001 - 85,000
$85,001 - 90,000
$95,001 - 100,000
Over $100,000
Are you willing to give the FFSC permission to communicate with your scholars' schools to collect information about their academic progress?
*
Yes
No
Maybe
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