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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