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, 1922
                 
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
L. McMillan Allen McMillan Aug 29 1915 Male None Tiger, Wash L. McMillan
  Ruth M. Hartman Apr 30 1908 Female 36   Tiger, Wash Mrs. J. C. Hartman
Mrs.  J. C. Hartman Christopher V. Hartman Mar 16 1906 Male 4 Tiger, Wash Working at Home
Mrs. M. B. Smith Selma Smith July 6 1908 Female 32 Tiger, Wash Mrs. M. B. Smith
Mrs. M. B. Smith Bertie Smith Dec  20 1905 Male None Tiger, Wash  
T. H. Blair Duston Blair June 8 1912 Male 36 Tiger, Wash T.H. Blair
J. N. McInturff Marshall McInturff Nov 9 1903 Male None Tiger, Wash Working at Home
J. N. McInturff Guy McInturff Feb 1 1906 Male None Tiger, Wash Working at Home
J. N. McInturff Lorring McInturff Feb 15 1909 Female 36 Tiger, Wash J. N. McInturff
J. N. McInturff Merle McInturff Aug 17 1910 Female 36 Tiger, Wash J. N. McInturff
J. N. McInturff Hilary McInturff Aug 20 1913 Female 36 Tiger, Wash J. N. McInturff
Mrs. S.H. Shaw Orville J. Shaw July 13 1902 Male None Tiger, Wash Working at Home
Mrs. S.H. Shaw Alfred M. Shaw Jan 26 1904 Male None Tiger, Wash Working at Home
Mrs. S.H. Shaw Alta M. Shaw Feb 28 1907 Female 36 Tiger, Wash  
Mrs. S.H. Shaw Oliver Shaw May 28 1909 Male 36 Tiger, Wash  
   FOREST HOME SCHOOL              
   Total Students in Class of 1922:  15           View Original Document N/A
   Forest Home School Teacher for 1922:  To Be Determined Salary per month:  TBD    
   Forest Home School Board Directors for 1922:  TBD            
   Forest Home School Board Clerk for 1922:  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