Application

 
CHILD
Name of Child
Name of Child
For which program are you applying?
Children who turn 2 by March 1 are eligible for the 2 and 3 Day Program, only. Children who turn 3 by December 1 are eligible for either the 2,3 or 5 Day programs. Children over the age of 5 by December 1 must enroll in the 5 Day program.
Are you applying for Tuition Assistance?
Admission decisions are unrelated to Tuition Assistance decisions; however, Tuition Assistance applications should be filed immediately following the application for admission.
Gender
Parent/Guardian 1
Address
Address
Phone
Phone
Current Status of Parent
Business Phone
Business Phone
Parent/ Guardian 2
Name
Name
Address
Address
Phone
Phone
Business Address
Business Address
Business Phone
Business Phone
Current Status of Parent
Supplemental
Does your child have an existing or pending special ed., special need or IEP document?
Has your child been asked to withdraw from any of these? *