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2023-2024 Preschool Application
Preschool Application
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Applicant
Student Name
*
First
Middle
Last
Preferred First Name
Gender
*
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Female
Male
Age
*
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1
2
3
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5
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Child's Age as of September 1, 2023
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2
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8
9
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13
Date of Birth
*
MM slash DD slash YYYY
Class Applying for
*
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Cubs (2/3 Years)
Pandas (3/4 Years)
Grizzly (Pre-K)
Full or Half Day?
*
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Full Day
Half Day
Home Address
*
Home Phone
*
Current School
*
Address of Current School
*
Telephone for Current School
*
Head of Current School
*
Previous Schools Attended / Dates of Attendance / Grade Levels
Applicants Primary Language / Other Language Spoken
Applicant’s Ethnicity (optional)
Does your student have any physical limitations or health conditions?
*
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Yes
No
If Yes, please explain physical limitations or health conditions
*
Family
Parent / Legal Guardian Name
*
First
Middle
Last
Address
*
Occupation
*
Employer
*
Home Phone
*
Work Phone
*
Cell Phone
*
Email
*
Parent / Legal Guardian Name
First
Middle
Last
Address
Occupation
Employer
Home Phone
Work Phone
Cell Phone
Email
Check all that apply:
*
parents together
parents separated
mother deceased
father deceased
parents divorced
father remarried
mother remarried
single parent
other
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:
Are you interested in Preschool only, Preschool through Kindergarten, or Preschool through Middle School at CDS?
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.
Application Fee
*
Application Fee
$0.00
Coupon Code
Credit Card
Card Details
Cardholder Name
Phone
This field is for validation purposes and should be left unchanged.
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