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2023-2024 Elementary and Middle School Application
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Elementary and Middle School Application
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Student Name
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Home Address
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Home Phone
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Address of Current School
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Telephone for Current School
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Head of Current School
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Previous Schools Attended / Dates of Attendance / Grade Levels
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Applicant’s Ethnicity
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Applicant's Ethnicity
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Does your student have any physical limitations or health conditions?
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Occupation
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Employer
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Home Phone
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Work Phone
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Email
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Parent / Legal Guardian Name
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Check all that apply:
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parents together
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father deceased
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With whom does the student reside?
Who has legal custody of the student?
Name of step-parent(s) if applicable:
Other children in the family (Name, Year of Birth, School):
Any unusual family situation:
Name of person financially responsible for tuition and fees:
How did you hear about Charlottesville Day School:
Any other information you would like us to have about your student:
Check here if you wish to have financial assistance information emailed to you.
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Application Fee
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