2022-2023 District Demographic Survey
Please complete this survey for ALL children under 21 years of age who have not graduated living at this address, including:  All Pre-School students and all K-12 Public, Private, or Home Schooled students.  

Providing information for Pre-School age children helps the District to prepare for Pre-K & Kindergarten registration and to ensure that adequate staff are available to meet all student needs.

 Completing this form does not register your child (children) for school, please contact the school to register any students who will be entering school in our District for the first time.
Sign in to Google to save your progress. Learn more
Email *
Primary Contact full name *
Relationship to Student *
Required
Secondary Contact full name
Relationship to Student
Home Address *
Home Phone Number *
County of Residence *
Student 1 Name *
Student 1 Birth Date *
MM
/
DD
/
YYYY
Student 1 Information *
Required
If student 1 not attending, reason why
If Attending Private School or Public School elsewhere selected above, indicate school attending below.
Student 2 Name
Student 2 Date of Birth
MM
/
DD
/
YYYY
Student 2 Information
If student 2 not attending, reason why
If Attending Private School or Public School elsewhere selected above, indicate school attending below.
Student 3 Name
Student 3 Date of Birth
MM
/
DD
/
YYYY
Student 3 Information
If student 3 not attending, reason why
If Attending Private School or Public School elsewhere selected above, indicate school attending below.
Student 4 Name
Student 4 Date of Birth
MM
/
DD
/
YYYY
Student 4 Information
If student 4 not attending, reason why
If Attending Private School or Public School elsewhere selected above, indicate school attending below.
Student 5 Name
Student 5 Date of Birth
MM
/
DD
/
YYYY
Student 5 Information
If student 5 not attending, reason why
If Attending Private School or Public School elsewhere selected above, indicate school attending below.
Student 6 Name
Student 6 Date of Birth
MM
/
DD
/
YYYY
Student 6 Information
If student 6 not attending, reason why
If Attending Private School or Public School elsewhere selected above, indicate school attending below.
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Pavilion Central School District. Report Abuse