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