Prospective Day School Application – Saint Anne's Day School & Enrichment Programs

Child's Full Name

Gender

Name Called

Date of Birth

Home Phone Number

Home Address

City

State

Zip Code

Parent 1

Parent 2

Work Number

Work Number

Cell Number

Cell Number

Email Address

School year child is applying for

Does your child have a sibling(s)?

Yes

No

Are you an active pledging member of St. Anne's Episcopal Church?

Yes

No

Do you have an interest in our full day care for Pre-Kindergarteners and Kindergarteners?

Yes

No

This is NOT a registration form. You will be contacted when space becomes available.

AN ADMINISTRATION FEE OF $55 IS DUE AT THE TIME OF SUBMISSION.