Student Demographic Questionnaire
The data in this form must be collected each year. The data is compiled and used to report outside agencies. No individual information is released.
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Email *
Student's First Name *
Sudent's Last Name *
Student will be entering what grade in the 24-25 school year? *
Student's Primary Home Street Address *
Student's Primary Home Zip Code *
What Neighborhood Association does the Primary Home belong to (i.e. Waverly, Evergreen, Sandtown-Winchester, etc.) *
Student's Ethnicity *
Student's Race (check all that apply) *
Required
Student's Religious Affiliation *
Does the Student live in a household with a single parent or caregiver? *
If Yes, Caregiver's Relationshop With Student *
Has either of the student's biological parents ever been incarcerated? *
If yes, which biological parent has been incarcerated? *
Are either of the student's biological parents deceased? *
Does the student qualify for Free or Reduced Lunch? *
Highest Education Biological Mother Achieved *
Highest Education Biological Father Achieved *
Name of Person Completing this Form *
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