Census Information/Address Form Hollidaysburg Area School District 405 Clark Street Hollidaysburg, PA 16648

Dear Resident:

Please complete the following Hollidaysburg Area School District Census Address Information Form. The District is required under Section 1351 of the Public School Code of Pennsylvania to perform a census annually to count all the children from birth to eighteen (18) years of age within the district and make any appropriate address changes. If there is no one under the age of 18 within your residence, you do not need to complete this census form.

You can complete the form online at http://tigerwires.com/census and submit. Or you can go to the district webpage under “announcements” and complete the form, print it out and mail. Send the completed form to Hollidaysburg Area School District, Census Office, 1510 N. Montgomery Street, Hollidaysburg, PA 16648.

If you have any questions or need any assistance, you may contact our office at 814-695-7537. Thank you for your time and cooperation.

Please fill in the following information and be sure to include which Borough or Township you reside in. Please also include any 911 address changes.

Allegheny Township Frankstown Township Juniata Township Blair Township Hollidaysburg Borough Duncansville Borough Newry Borough

Family Last Name: Phone: ( )

Current Address: City: State: Zip Code

Adults Over 18 Last First MI. Date of Birth 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. (If more than 10 adults – add the additional names under the minors section)

Minors Under Age 18 Last First MI. School Grade Date of Birth 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. (If more than 10 children – add the additional names under the adults section)