Enrollment Application

Clear Form
☐ 2019-20
☐ 2020 Summer
☐ 2020-21
☐ 2021 Summer
☐ 2021-22
☐ Primary (3-6y): (M-Th) Morning (9:00a-12:00p)
☐ Primary (3-6y): (M-Th) Morning & Extended Lunch (9:00a-12:45p)
☐ Primary (3-6y): (M-F) Morning (9:00a-12:00p)
☐ Primary (3-6y): (M-F) Morning & Extended Lunch (9:00a-12:45p)

Child

☐ M
☐ F

Parent / Guardian 1

Parent / Guardian 2

List other adults who are authorized to pick up your child.
First NameLast NameRelationshipPhone NumberAddress

Background information

Please list every school that your child has attended
What are your educational goals for your child? How do you see us facilitating these goals?
What role can we expect the child's parent(s)/guardian(s) to play in facilitating this child's educational goals?
Does your child have any hobbies, sports, or special interests, capabilities or talents?
How do you see your child in their social and emotional development?
Please describe your child's educational experience thus far. What has been successful? What has been challenging?
Has your child had any remedial work, special tutoring, or enlightenment classes in the past two years? Please explain.
Does your child have any special needs (dietary, educational, medical, or psychological)? Has your child received any testing or evaluations that would relate to their academic or social performance? Please have copies sent of tests or evaluations that your child has taken.
Are there any areas in which we may be able to give special help and encouragement to your child?