<?xml version="1.0" encoding="Windows-1252"?>
<NonpublicSchoolStudentRosterGroup SchemaVersionMajor="2023-2024" SchemaVersionMinor="1" CollectionId="269" CollectionName="NonpublicSchoolStudentRoster" SubmittingSystemVendor="My System Vendor" SubmittingSystemName="My System" SubmittingSystemVersion="1.0" xsi:noNamespaceSchemaLocation="https://cepi.state.mi.us/MSDSXML/MSDS/2023-2024/NonpublicSchoolStudentRoster2023-20241.xsd" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
  <NonpublicSchoolStudentRoster>
    <SubmittingEntity>
      <SubmittingEntityTypeCode>B</SubmittingEntityTypeCode>
      <SubmittingEntityCode>07637</SubmittingEntityCode>
    </SubmittingEntity>
    <PersonalCore>
      <UIC>4848327119</UIC>
      <LastName>Frog</LastName>
      <FirstName>Kermit</FirstName>
      <MiddleName>Rohan</MiddleName>
      <StudentSuffix>Sr.</StudentSuffix>
      <DateOfBirth>2007-11-12</DateOfBirth>
      <MultipleBirthOrder>2</MultipleBirthOrder>
      <Gender>M</Gender>
    </PersonalCore>
    <SchoolDemographics>
      <OperatingDistrictNumber>84000</OperatingDistrictNumber>
      <SchoolFacilityNumber>07637</SchoolFacilityNumber>
      <StudentIdNumber>student124</StudentIdNumber>
      <GradeOrSetting>11</GradeOrSetting>
    </SchoolDemographics>
    <PersonalDemographics>
      <ResidentLEANumber>19140</ResidentLEANumber>
      <StudentResidentCounty>82</StudentResidentCounty>
      <Ethnicity>000010</Ethnicity>
    </PersonalDemographics>
    <Contacts>
      <AddressTypeDescriptor>Physical</AddressTypeDescriptor>
      <StreetNumberName>123 Road</StreetNumberName>
      <ApartmentRoomSuiteNumber>A1</ApartmentRoomSuiteNumber>
      <City>Lansing</City>
      <StateAbbreviationDescriptor>MI</StateAbbreviationDescriptor>
      <PostalCode>48917</PostalCode>
      <TelephoneNumber>9895552134</TelephoneNumber>
    </Contacts>
    <Contacts>
      <AddressTypeDescriptor>Mailing</AddressTypeDescriptor>
      <StreetNumberName>3077 Road2</StreetNumberName>
      <ApartmentRoomSuiteNumber>B52</ApartmentRoomSuiteNumber>
      <City>Fowler</City>
      <StateAbbreviationDescriptor>MI</StateAbbreviationDescriptor>
      <PostalCode>48835</PostalCode>
    </Contacts>
    <HomelessDemographics>
      <Homeless>15</Homeless>
      <UnaccompaniedYouth>false</UnaccompaniedYouth>
    </HomelessDemographics>
    <SNE>
      <SupplementalNutritionEligibility>1</SupplementalNutritionEligibility>
    </SNE>
  </NonpublicSchoolStudentRoster>
</NonpublicSchoolStudentRosterGroup>