2022-2023 Kindergarten Census Form
Use this form to provide the Plainview-Old Bethpage CSD with current contact information for the purpose of enrolling a student for kindergarten in the upcoming school year.

(1 student per form, please)
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Email *
Parent/Guardian Last Name: *
Parent/Guardian First Name: *
Street Address: *
City: *
Zip Code: *
Phone Number: *
Last name of new kindergarten student: *
First name of new kindergarten student: *
Date of birth of new kindergarten student: *
MM
/
DD
/
YYYY
Gender of new kindergarten student: *
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