Application For Admission

Student Information:

Family Information:

Scholastic Information:

Emergency Contacts / Authorized Pickup:

List the names of three (3) adults who will assume responsibility in the event you can't be reached, who are allowed to pick up your student(s)

Demographic Survey:

Please provide copy of birth certificate
Student Health History
Does the student have any of the following? If so, please describe.
Please check the appropriate boxes regarding health concerns that pertain to the student
Please list any serious illnesses, injuries and/or surgeries