| Form 19B | ||||||||
| CENSUS BLANK | ||||||||
| CENSUS OF CHILDREN between the Ages of Four/Five and Twenty-one Years, Residing in School District No. 7 | ||||||||
| Pend Oreille County, Washington, on the First Day of May, 1921 | ||||||||
| NAMES OF PARENTS OR
GUARDIANS (As entered by School Board Clerk) |
NAMES OF CHILDREN | DATE OF BIRTH | SEX | No. of Weeks Child Has Attended School During School Year | POSTOFFICE ADDRESS | SIGNATURE OF PARENT OF GUARDIAN | ||
| Month | Day | Year | I certify, upon honor, that the foregoing information is correct | |||||
| J. C. Hartman | Ruth M. Hartman | Apr | 30 | 1908 | Female | 32 | Tiger, Wash | Mrs. J. C. Hartman |
| J. C. Hartman | Christopher V. Hartman | Mar | 15 | 1906 | Male | 31 | Tiger, Wash | Mrs. J. C. Hartman |
| M. B. Smith | Thelma M. Smith | July | 6 | 1908 | Female | 24 | Tiger, Wash | Mrs. M. B. Smith |
| M. B. Smith | John B. Smith | Dec | 24 | 1915 | Male | None | Tiger, Wash | Mrs. M. B. Smith |
| O. Kennedy | C. L. Kennedy | Mar | 27 | 1911 | Male | 34 | Tiger, Wash | O. Kennedy |
| O. Kennedy | D. O. Kennedy | July | 29 | 1913 | Male | 34 | Tiger, Wash | O. Kennedy |
| O. Kennedy | Florence L. Kennedy | Sep | 14 | 1915 | Female | 0 | Tiger, Wash | O. Kennedy |
| T. H. Blair | Dustin Blair | June | 8 | 1913 | Male | None | Tiger, Wash | Mrs. H. Blair |
| O. C. Isom | Genevieve L. Isom | Sep | 10 | 1911 | Female | 28 | Tiger, Wash | Mrs. O. C. Isom |
| J. N. McInturff | Cataleen McInturff | Oct | 24 | 1900 | Female | None | Tiger, Wash | J. N. McInturff |
| J. N. McInturff | Josling McInturff | Feb | 15 | 1909 | Female | 32 | Tiger, Wash | J. N. McInturff |
| J. N. McInturff | Merle McInturff | Aug | 17 | 1910 | Female | 32 | Tiger, Wash | J. N. McInturff |
| J. N. McInturff | Marshall B. McInturff | Nov | 9 | 1903 | Male | None | Tiger, Wash | J. N. McInturff |
| J. N. McInturff | Guy McInturff | Feb | 1 | 1906 | Male | 32 | Tiger, Wash | J. N. McInturff |
| J. N. McInturff | Hilory McInturff | Aug | 20 | 1913 | Male | 32 | Tiger, Wash | J. N. McInturff |
| O. C. Isom | M. Dana Isom | July | 9 | 1901 | Male | 31 | Tiger, Wash | O. C. Isom |
| L. McMillan | Allen McMillan | Aug | 29 | 1915 | Male | None | Tiger, Wash | L. McMillan |
| FOREST HOME SCHOOL | ||||||||
| Total Students in Class of 1921: 17 | View Original Document N/A | |||||||
| Forest Home School Teacher for 1921: To Be Determined | Salary per month: TBD | |||||||
| Forest Home School Board Directors for 1921: TBD | ||||||||
| Forest Home School Board Clerk for 1921: TBD | ||||||||
| Information in () are possible alternative interpretations | ||||||||
| Original Document Courtesy - | Transcription of Orginal Document by - | |||||||
| State of Washington, Eastern Regional Archives - Cheney, WA | Tiger Historical Center Board Director John Nordstrand | |||||||
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