School District #82 will be conducting a school census during the month of June. In order to get the most accurate and complete number and names of persons living within our district, we are asking the patrons to complete the attached questionnaire. It is important for one form to be filled out for each household. This includes single parent families, single individuals, etc. Please enter only the names of individuals who live in your household. Please return the completed questionnaire to the school office or mail it to the Superintendent's Office, P.O. Box 487, Wilber, NE 68465

Please send in the following information. 

Family Name: (Last name)        

Male Name:                

Female Name:            

Street Address                

Box Number or Apt Number               

City                          

State & Zip                

Email Address

Names of all children under 21 (Include children attending college who are living away from home or serving in the Armed Forces)

Child 1 

Name:            

Date of Birth  

Place of Birth  

Gender    Male Female   

Age            Grade   

Child 2 

Name:            

Date of Birth  

Place of Birth  

Gender    Male Female   

Age            Grade   

Child 3

Name:            

Date of Birth  

Place of Birth  

Gender   Male     Female   

Age            Grade   

Child 4

Name:            

Date of Birth  

Place of Birth  

Gender   Male        Female   

Age            Grade   

Child 5

Name:            

Date of Birth  

Place of Birth  

Gender    Male Female   

Age            Grade

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