Note - This Online Census Form is No Longer Available as of 6/1/19. Please use the paper mail form for all responses. Thank you.

Warwick School District Census Form

Please review instructions before completing
Online Instructions

If you have any questions, please call the district at 717-626-3734, or email us at census@warwicksd.org.
Warwick School District
301 W. Orange Street
Lititz, PA 17543

Note: Options for Completing:
1) No Change - Check box, Fill in Residence # and Name at bottom of form
2) Changes - Check box, Fill in Residence #, Name at bottom, and areas where changes are needed.
3) New Information - Check box, Fill in complete form.

Enter your Residence ID# from the top left box of the form you received in the mail. Note - Do NOT enter your mailing address here!

(All CAPS)
(Include DASH as shown)
Residence #


Residence/Street Address
Street:
Apt #: City:
State: Zip:




THIS SECTION FOR ADULTS 18 AND OVER
Name of Adult
(Last, First, Middle Initial)
Delete Name
(Put an X to
Delete Name)
Gender
 
Birthdate
(00/00/0000)
Race
 
Relationship
 
1. Last Name:
First Name: MI:
2. Last Name:
First Name: MI:
3. Last Name:
First Name: MI:
4. Last Name:
First Name: MI:
5. Last Name:
First Name: MI:

THIS SECTION FOR CHILDREN UNDER 18 OR STILL IN HIGH SCHOOL
Name of Child
(Last, First, Middle Initial)
Delete Name
(Put an X to
Delete Name)
Gender Birthdate
(00/00/0000)
Race Name of School
(Current Year)
Grade
(Current Year)
1. Last Name:
First Name: MI:
2. Last Name:
First Name: MI:
3. Last Name:
First Name: MI:
4. Last Name:
First Name: MI:
5. Last Name:
First Name: MI:
6. Last Name:
First Name: MI:
7. Last Name:
First Name: MI:
8. Last Name:
First Name: MI:
9. Last Name:
First Name: MI:
10. Last Name:
First Name: MI:

If you expect to move prior to July 1, please note date and new address: Date:
Street:
Apt:
City/State/Zip:

ALL INFORMATION IS CONFIDENTIAL

I verify that the information above is complete and accurate:
Full Name:
Date:12/13/2019
Telephone Number:   Check if Unlisted
  Must check a box 1,2 or 3 at top of form before submitting.


If you have any questions, please call the district at 717-626-3734, or email us at census@warwicksd.org
Warwick School District
301 W. Orange Street
Lititz, PA 17543

If you experience any trouble with the form, please contact us at info@dhfassociates.com

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