We’re excited to meet you!

Online Student Application

Your Name and Relationship to Student

Please provide your name and your relationship to the student

Your Student's Name

First Name

Last Name

Nickname/Preferred Name (if applicable)

Your Phone Number

Your Email

Check Your Preferred Program

School Day

Extended Day

Early Bird

Afternoon Adventures

Gender

Male

Female

Your Student's Age

If your Student has any known handicaps, health or behavioral issues, please explain:

Physician's Name

Physician's Phone Number

Allergies -please include all allergies to medication, food, plants, animals, and seasonal allergies

If your child requires an epipen, please provide the school with one and fill out an Administration of Medication Form

Student's Behavior

Please advise us of any situation involving home/family that might affect your child's behavior at school. If your child has any known handicaps, health or behavioral issues, please explain.

Step 2: Parent/Guardian Form

Name

First Name

Last Name

Email Address

Cell Phone

(###)

###

####

Work Phone

(###)

###

####

Personal Address and Phone

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Employer Address and Phone

Employer

Employer Phone

(###)

###

####

Employer Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

After filling out the Student Application (either online or by PDF print below)
you may be asked to complete the Parent/Guardian form as well. Thanks!