Application for Admission Application for AdmissionChild’s Full Name* Child's First Name Child's Last Name Birth Date (MM/DD/YYYY)* Date Format: MM slash DD slash YYYY Starting Date (MM/DD/YYYY)* Date Format: MM slash DD slash YYYY Siblings & AgesPlease accept my child below for the following program:*Young-Preschoolers-1-2Pre-Primary-2-3Primary-3-5KindergartenGrade 1Grade 2Grade 3Grade 4Grade 5Grade 6Select Young-Preschoolers Program Schedule*8:30am – 12:30pm - 3 day8:30am – 12:30pm8:30am – 3:00pm8:30am – 3:00pm - 3 day8:30am – 3:00pm - 2 daySelect Pre-Primary Program Schedule*8:30am – 12:30pm8:30am – 12:30pm - 3 day8:30am – 3:00pm8:30am – 3:00pm - 2 day8:30am – 3:00pm - 3 daySelect Primary Program Schedule*8:30am – 12:30pm8:30am – 12:30pm - 3 day8:30am – 3:00pm8:30am – 3:00pm - 3 daySelect Elementary Program Schedule*8:30am - 3:00pmExtended Care:*YesNoBefore Care: From 7:30am*YesNoAfter Care Until:*4:30pm5:30pmParent’s InformationParent #1 Name* First Last Parent’s Occupation*Name of CompanyHome Phone*Business/Cell PhoneHome Address* Street Address City State / Province / Region ZIP / Postal Code Business Address Street Address City State / Province / Region ZIP / Postal Code Parent Email* Do you want to add a second parent?*YesNoParent #2 Name* First Last Parent’s Occupation*Name of CompanyHome Phone*Business/Cell PhoneHome Address* Same as parent #1 Street Address City State / Province / Region ZIP / Postal Code Business Address Street Address City State / Province / Region ZIP / Postal Code Parent Email* If your child attended a preschool or a playgroup before, list its name and briefly describe any significant experiences of your child.Please describe your child giving his/her habits, reactions, any medical conditions requiring special attention, such as allergies to food, pollen, grass, etc.*What would you like this school to accomplish for your child?*How did you hear about this school?*Check the box beside the statement* I understand that upon enrollment, I am required to provide proof of my child’s identity and age to the school: copy of birth certificate and a medical form signed by a doctor. I further understand this application is not accepted or to be considered such until the pupil is interviewed with one or both parents and notice of acceptance is received. There will be an application fee of $75. Payment through Brightwheel is preferred, though checks and cash are also accepted. This fee is not refundable for any reason. Signature*Date* Date Format: MM slash DD slash YYYY
