Please complete the following information about your household

  1. Head of Household Information
  2. Secondary Guardian Information
  3. Email and Phone Information
  4. Address Information
  5. Emergency Contact Information
  6.   Name of Emergency Contact (First)Name of Emergency Contact (Last)Contact Phone w/ area codeRelationship
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  8. Disclaimer
  9. The only information the Town will obtain about you when you visit this site is the information you provide to it. The Towns use and dissemination of the information you provide is governed by the New York Public Records Law, the New York Fair Information Practices Act, and laws relating to the confidentiality of tax, wage reporting, and child support information. The Town does not sell or rent information about its users, but it may share or exchange information in accordance with the above mentioned laws.

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