ALABAMA STATE DEPARTMENT OF EDUCATION
Migrant Employment Survey
NAME OF SCHOOL
Aliceville Elementary School
Aliceville High School
Gordo Elementary School
Gordo High School
Pickens County Early Learning Center
Pickens County High School
Reform Elementary School
School year
2021-2022
GRADE LEVEL
PreKDG
KDG
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
STUDENT'S NAME
NAME OF PARENT/GUARDIAN
ADDRESS
City, State, and ZIP Code
Phone Number (include ZIP Code)
Have you moved during the last three years to work or to seek work even if it was for a short period of time?
Yes
No
Are you or your spouse working or have you worked in an activity directly related to some of the following? Please, check (√) all applicable:
The production or process of harvests, milk products, poultry farms, poultry plants, cattle farms
Fruit farms
The cultivation or cutting of trees
Work in nurseries or sod farms
Fish or shrimp farms
Worm farms
Catching or processing seafood (shrimp, oysters, crabs, fish, etc.)
From what city, state, or country did you come from?
What type of work did you or your spouse do before coming here?
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