PRESCHOOL-AGED CENSUS SURVEY
SARANAC LAKE CENTRAL SCHOOL DISTRICT
79 CANARAS AVE
SARANAC LAKE, NY 12983

This form is intended for parents who have preschool-aged children that will enter Kindergarten in September of 2016 or later. Thank you in advance for filling out this Census survey.
PLEASE USE ONE FORM PER CHILD.

Child's First Name
Your answer
Child's Middle Name
Your answer
Child's Last Name
Your answer
Child's Birthdate
Your answer
Child's Gender
Parent/Guardian First Name
Your answer
Parent/Guardian Last Name
Your answer
Child's Home Address (Child's Primary Residence)
Your answer
City, State, Zip Code
Your answer
Mailing Address if Different (If same as residence type "same")
Your answer
County of Residence
Your answer
Primary Phone Number
Your answer
Alternate Phone Number
Your answer
First Name of Person Submitting This Form
Your answer
Last Name of Person Submitting This Form
Your answer
Relation to Child
Email of Person Submitting This Form
Your answer
Submit
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