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2023 / 2024 LA VERGNE SPECIAL CENSUS

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This form has been modified since it was saved. Please review all fields before submitting.

The information collected will be kept confidential and will ONLY be used by the City of La Vergne for the Special Census. Your information will not be shared, sold, rented or given to any other entity or business.
Please enter first and last name of each resident in the household including military, college students, or others living away.
Street number:*
(Example: 5093)
Street name:*
(Example: Murfreesboro)
Street type*
(Example: Road)
Apartment number:
(Example: Apt 101)
City:*
How many total residents live at this address?*
Your legal FIRST name:*
Your legal LAST name:*
Resident #2 legal FIRST name:
Resident #2 legal LAST name:
Resident #3 legal FIRST name:
Resident #3 legal LAST name:
Resident #4 legal FIRST name:
Resident #4 legal LAST name:
Resident #5 legal FIRST name:
Resident #5 legal LAST name:
Resident #6 legal FIRST name:
Resident #6 legal LAST name:
Resident #7 legal FIRST name:
Resident #7 legal LAST name:
Resident #8 legal FIRST name:
Resident #8 legal LAST name:
Resident #9 legal FIRST name:
Resident #9 legal LAST name:
Resident #10 legal FIRST name:
Resident #10 legal LAST name:
Additional Resident First and Last Names: (One per line)