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District Register Census

Is Your Child in our Census?
If you are a Middleton-Cross Plains Area School District resident and have children (birth through 18 years of age) not currently enrolled in our District, we would like to hear from you.

Why is it important that you fill this out?

It helps us plan for future enrollment in our District.
It enables the district to provide you with further information.

Middleton-Cross Plains Area School District
Census Information

Adult Household Members: (Mother, Father, Guardian, etc.)

Adult 1

First Name *

Last Name *

Gender

male

female

Relationship to Child

Adult 2

First name

Last Name

Gender

male

female

Relationship to Child

Household Address

House No., Prefix, Street Name, Suffix, Type, Apartment No.

City

State

Zip Code

Home Phone *

Email Address of Person Submitting this Census *

All Children Not Currently Attending The Middleton-Cross Plains Area School District

Child 1

First Name

Last Name

Date of Birth

Month

Day

Year

Gender

male

female

Current School/Grade (if applicable)

Hispanic

Hispanic

Non-Hispanic

State Defined Ethnic/Race

Asian/Pacific Islander

Black

Native American

White

Child 2

First Name

Last Name

Date of Birth

Month

Day

Year

Gender

male

female

Current School/Grade (if applicable)

Hispanic

Hispanic

Non-Hispanic

State Defined Ethnic/Race

Asian/Pacific Islander

Black

Native American

White

Child 3

First Name

Last Name

Date of Birth

Month

Day

Year

Gender

male

female

Current School/Grade (if applicable)

Hispanic

Hispanic

Non-Hispanic

State Defined Ethnic/Race

Asian/Pacific Islander

Black

Native American

White

Child 4

First Name

Last Name

Date of Birth

Month

Day

Year

Gender

male

female

Current School/Grade (if applicable)

Hispanic

Hispanic

Non-Hispanic

State Defined Ethnic/Race

Asian/Pacific Islander

Black

Native American

White