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Form 19B
CENSUS BLANK
CENSUS OF CHILDREN between the Ages of Four/Five and Twenty-one Years, Residing in School District No. 12
Pend Oreille County, Washington, on the First Day of May, 1912
 
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
F. Oswald William Oswald Aug 19 1905 Male None Cusick Mrs. F. Oswald
C.G. Barnet Geo. Barnet Apr 28 1904 Male   Cusick Geo Barnet
Ester Ing Alice Ing   25 1900 Female   Cusick Esther Ing for C. S. Barnett
A. Crown Carl Crown Nov 17 1897 Male   Cusick A. Crown
A. Crown Albert Crown Jun 5 1901 Male   Cusick  
A. Crown Harold Crown June 19 1903 Male   Cusick  
  Sam Holcomb Aug 18 1898 Male   Cusick Herrica Holcomb
E. L. Wetzler Elnor Metzler Jun 21 189? Female   Cusick  
E. L. Wetzler Gladys Metzler May 3 190? Female   Cusick Mrs. E. L. Wetzler
E. L. Wetzler Susey Metzler Aug 21 1907 Female   Cusick  
R. Johnson Sarah M. Johnson Jan 27 1900 Female   Cusick Mrs. R. H. Johnson
D. R. Atterton Gladys Aterton Sep 29 1901 Female   Cusick Mrs. DS. R. Atherton
Geo Rippey Harold Rippey May 19 1904 Male   Cusick G. C. Rippey
Don Markovich Homer Rippey Jun 5 1906 Male   Cusick  
Don Markovich Andrew Markovich Apr 20 1896 Male   Cusick Dorcel Markovich
Don Markovich Anna Markovich Mar 26 1900 Female   Cusick  
Don Markovich Rosa Markovich Feb 18 1902 Female   Cusick  
Don Markovich Lizzie Markovich Sep 11 1906 Female   Cusick  
L. E. Purchase Rolland Purchase July 1 1908 Male   Cusick L. E. Purchase
  Ed S. Leuck Aug 24 189? Male   Cusick Emma Leuck
  Anna Leuck Dec 28 1896 Female   Cusick  
W. A. Wiggins Geo. Higgins Nov 10 1893 Male   Cusick  
W. A. Wiggins Dwight Higgins Sep 20 1898 Male   Cusick  
W. A. Wiggins Ruth Higgins Jun 22 190? Female   Cusick  
CUSICK SCHOOL              
Total Students in Class of 1912: 24 (13 boys, 11 girls)           View Original Document N/A
Cucsick School Teacher for 1912:  To Be Determined Salary per month:  TBD    
Cusick School Board Directors for 1912:  TBD            
Cusick School Board Clerk for 1912:  TBD              
                 
Information in () are assumed 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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