New Baby Census Form

New Baby? New to Town? Moved recently? It is important for our future planning to get all children on our census files. You will then receive updates from the District 196 Early Childhood Family Services program and preschool screening information before kindergarten. Please fill out the following form and press the submit button when done. Thank you. Please Note: A new baby is any child, under the age of 5, who is new to Indpendent School District 196. Please call 651.423.7639 with any questions or to answer these questions over the phone.
New baby's name and birthdate
*Baby's name	First	MI.	Last
*Baby's birthdate		Day	Year
Complete address of new baby
*Address	apt.#
*City, state, zip
Full name of parent/guardian 1 living at this address
*Parent/ guardian 1
Previous Address	apt.#
Previous City, state, zip
Full name of parent/guardian 2 living at this address
Parent/ guardian 2
Previous Address	apt.#
Previous City, state, zip
Full names and birthdates of anyone else living in home. Please include all adults and children.
Other occupant 1
Name	First	MI.	Last
Birthdate		Day	Year
Other occupant 2
Name	First	MI.	Last
Birthdate		Day	Year
Other occupant 3
Name	First	MI.	Last
Birthdate		Day	Year
Other occupant 4
Name	First	MI.	Last
Birthdate		Day	Year

	In the event that we have any questions, please include your email address and phone number below.
Your email address
Your phone Number

Questions?
Call 651.423.7639, Monday through Friday, 8 a.m. to 4:30 p.m.