Pathfinder Village Community and School for Down Syndrome Adults and Children

The following on-line form is for those visitors interested in admission information for Pathfinder Village. For non-admission inquiries, please visit the How to Help or Contact Us sections in the website. You may also want to visit our Privacy section before sending any information to us.

How did you hear of Pathfinder Village?



Contact Information: (* denotes required fields):

*Full Name:

*E-mail:

*Street:

(con'td)

*City:

*State:

*Postal Code:

Country:

*Day Phone:

Cell Phone:

Basic Information: Tell us about the person you are seeking placement for:

     Person has Down syndrome?     Yes       No

     Person's Gender?       Male     Female

     Person's Age?

     Person's Name?

Independence Level:

Medical Profile (check all that apply):

Cardiac Condition

Endocrine Condition

Digestive Condition

Psychiatric Condition (please describe)

Behaviors of Concern (please describe)

Other (please describe)

What admissions questions/concerns do you have?

Thank you! A response will be sent to you soon.

National Organizations:
NDSS	NDSC

Pathfinder Village

3 Chenango Road

Edmeston, New York

13335-2314

info@pathfindervillage.org

(607) 965-8377