Bethlehem Central School District Student Census
Please complete the questionnaire below and submit your information.

The District's pre-school and non-enrolled student census questionnaire helps us to accurately project future class sizes, arrange transportation routes, and allocate resources to our neighborhood schools.

Questions? Call the Registrar: 518-439-0352

Do you have pre-school aged children living in your household?
Name of Pre-School Child
Your answer
Date of Birth of Pre-School Child
Your answer
Gender Pre-School Child
Name of Pre-School Child #2
Your answer
Date of Birth of Pre-School Child #2
Your answer
Gender of Pre-School Child #2
Do you have school-aged children not enrolled through Bethlehem Central School District?
Name of School-Aged Child
Your answer
Date of Birth of School-Aged Child
Your answer
Gender of School-Aged Child
School of Attendance for School-Aged Child
(Private/Home/Etc.)
Your answer
Current Grade of School-Aged Child
Your answer
Parent 1 Information
Name
Your answer
Address
Your answer
City
Your answer
State
Your answer
Zip Code
Your answer
Business Phone Number
Your answer
Home Phone Number
Your answer
Cell Phone Number
Your answer
E-mail Address
Your answer
Do you want to receive the District's e-newsletter?
Parent 2 Information
Name
Your answer
Address
Your answer
City
Your answer
State
Your answer
Zip Code
Your answer
Business Phone Number
Your answer
Home Phone Number
Your answer
Cell Phone Number
Your answer
E-mail Address
Your answer
Do you want to receive the District's e-newsletter?
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service