Parent Database Update Form Please use this form to update your information on our database. Please contact Patrayia Kinloch, Database Manager at 718-398-6738 ext. 8537 with any questions. Name *FirstLastAddressAddress Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeEmail *Primary PhoneCell PhoneItems To Be UpdatedNameAddressTelephoneEmailAdd ChildEmployment StatusSubsidy Eligibility/Income EligibilityOther (please indicate below)Please check off items that need to be updated and indicate new information below.OtherEmailSubmit