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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