SY24-25: FACE Enrollment

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📝Introduction:

Welcome to the FACE Enrollment Form. This form is to be completed at the time of enrollment in the FACE Program.

Purpose: This form is designed to collect information needed for each family member who is enrolling in FACE this school year.
Who Should Fill Out the Form: This form is to be completed by all family members planning to participate in any FACE Component. Only one form is needed per family.

🗒️Instructions:

Please review the following information before beginning the enrollment process:

Gather all first names, last names, and dates of birth of all adults and children planning to participate in any FACE component.
Each family must contain at least one adult (primary family contact) and one child (the child can be prenatal).
Complete all fields possible - if waiting on a NASIS number for any family members, leave blank.

❓For more information review the Frequently Asked Questions on the FACE Portal or contact the FACE Data Team at: FACE_DataTeam@lsgface.onmicrosoft.com.

FACE Enrollment - Family Overview

FACE School

Adults Enrolling in FACE

Please enter the name of each adult who will be enrolling in FACE for the 2024-2025 school year.

	First Name	Middle Name	Last Name	Date of Birth
Adult 1 (Primary Contact for Family)
Adult 2
Adult 3

Children Enrolling in FACE

Please enter the name of each child who will be enrolling in FACE for the 2024-2025 school year.

	First Name	Middle Name	Last Name	Date of Birth
Child 1
Child 2
Child 3
Child 4
Child 5

Prenatal (unborn) child
(do not add prenatal
child to child list above,
until child is born)

YesNo

Due Date

Home Literacy

About how many adult books are in your home?

About how many children's books are in your home?

IN THE PAST 30 DAYS - How many children’s books were brought into your home?

Emergency Contact

Please enter emergency contact information for yourself and your children below:

Emergency Contact First Name:

Emergency Contact Last Name:

Emergency Contact Phone Number:

Adult Information

First Name

Last Name

Suffix

NASIS #

Tribal Affiliation

Date of Birth

Gender

If other, please enter gender or gender identity:

Phone

If other reason for enrolling, please describe

What is the highest level of education or degree completed?

Less than high school diploma	Received a high school diploma
Completed a GED	Received/completed a certificate, trade apprenticeship, or job training program
Completed some college course(s)	Received a 2-year Associate Degree
Received a Bachelor’s Degree	Received a Master’s Degree
Other

If less than a high school diploma, what was the highest grade completed?

If some college courses have been completed, how many credit hours did you complete?

If you have received/completed a certificate, trade apprenticeship, or job training program, describe:

If other, please describe highest grade completed:

Are you currently attending school (other than FACE adult education)?

YesNo

If you are currently attending another school, please enter the name of the school:

What is your current employment status?

Employed Full-TimeEmployed Part-TimeUnemployed (seeking employment)Not in the workforce (stay at home parent, retired, etc.)

If employed, approximately how many hours a week do you work?

How well do you do each of the following?

	Not at all	Not very well	Pretty well	Very well
Speak English?
Read English?
Write English?
Understand someone speaking English?
Speak your Indigenous language?
Read your Indigenous language?
Write your Indigenous language?
Understand someone speaking your Indigenous language?

Adult Information

First Name

Last Name

NASIS #

Tribal Affiliation

Date of Birth

Gender

If other, please enter gender or gender identity:

Phone

If other reason for enrolling, please describe

If less than a high school diploma, what was the highest grade completed?

If some college courses have been completed, how many credit hours did you complete?

If received a certificate, describe:

If other, please describe highest grade completed:

Are you currently attending school (other than FACE adult education)?

YesNo

If you are currently attending another school, please enter the name of the school:

What is your current employment status?

Employed Full-TimeEmployed Part-TimeUnemployed (seeking employment)Not in the workforce (stay at home parent, retired, etc.)

If employed, approximately how many hours a week do you work?

How well do you do each of the following?

	Not at all	Not very well	Pretty well	Very well
Speak English?
Read English?
Write English?
Understand someone speaking English?
Speak your Indigenous language?
Read your Indigenous language?
Write your Indigenous language?
Understand someone speaking your Indigenous language?

Adult Information

First Name

Last Name

NASIS #

Tribal Affiliation

Date of Birth

Gender

If other, please enter gender or gender identity:

Phone

If other reason for enrolling, please describe

If less than a high school diploma, what was the highest grade completed?

If some college courses have been completed, how many credit hours did you complete?

If received a certificate, describe:

If other, please describe highest grade completed:

Are you currently attending school (other than FACE adult education)?

YesNo

If you are currently attending another school, please enter the name of the school:

What is your current employment status?

Employed Full-TimeEmployed Part-TimeUnemployed (seeking employment)Not in the workforce (stay at home parent, retired, etc.)

If employed, approximately how many hours a week do you work?

How well do you do each of the following?

	Not at all	Not very well	Pretty well	Very well
Speak English?
Read English?
Write English?
Understand someone speaking English?
Speak your Indigenous language?
Read your Indigenous language?
Write your Indigenous language?
Understand someone speaking your Indigenous language?

Thank you for completing this form!

FACE Staff Member Email:

Has this family completed a BIE FACE Media Release Form?

YesDeclined to sign

Media Release Form (please upload):

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Contact Information

Apache	Blackfeet	Cherokee	Cheyenne	Choctaw
Cree	Crow	Dakota	Diné/Navajo	Eskimo
Hopi	Iñupiaq	Keres	Lakota	Menominee
Muskogee	Nakota	O'odham/Pima	Ojibwa	Oneida
Piipaash/Maricopa	Potawatomi	Shoshoni	Tewa	Tiwa
Twulshootseed	Ute	Yupik	Zuni	Other

To improve my parenting skills	To understand child development
To prepare my child for school	To help my child get along with others and socialize
To be more involved in my child's school	To help me obtain a GED or high school diploma
To improve my academic skills so I can go to college/technical school or get other training/education	To help me with my college/technical school coursework
To improve my reading skills	To improve my employability skills
To get a job	To make friends
To improve my family’s well-being	To obtain help in identifying and accessing resources for family and individual support
To improve my Indigenous language skills and cultural knowledge	To increase my community involvement
To improve my health and fitness	Other

To improve my parenting skills	To understand child development
To prepare my child for school	To help my child get along with others
To be more involved in my child's school	To help me obtain a GED or high school diploma
To improve my academic skills so I can go to college/technical school or get other training/education	To help me with my college/technical school coursework
To improve my reading skills	To improve my employability skills
To get a job	To make friends
To improve my family’s well-being	To obtain help in identifying and accessing resources for family and individual support
To improve my Indigenous language skills and cultural knowledge	To increase my community involvement
To improve my health and fitness	Other

To improve my parenting skills	To understand child development
To prepare my child for school	To help my child get along with others
To be more involved in my child's school	To help me obtain a GED or high school diploma
To improve my academic skills so I can go to college/technical school or get other training/education	To help me with my college/technical school coursework
To improve my reading skills	To improve my employability skills
To get a job	To make friends
To improve my family’s well-being	To obtain help in identifying and accessing resources for family and individual support
To improve my Indigenous language skills and cultural knowledge	To increase my community involvement
To improve my health and fitness	Other

Mother	Father
Grandparent	Foster Parent
Other