Date of Last Upload: Friday, March 31, 2023 Student Enrollment Form

   New Student Information
Select the Submit Application tab after you have filled in all information including students, primary and secondary family, and emergency/contacts. Use the tab buttons to select the pages to fill in the information. Required fields are bold.

Student 1

*First Name*Last NameMiddle NamePreferred Name*Date of Birth (mm/dd/yyyy)*Gender*E-Mail*ProgramEnrolled Siblings - Names with Ages STUDENT MEDICAL INFORMATION*Allergies*Health Issues*Regular Medication*Hospital Preference GENERAL INFORMATIONPresent SchoolPresent Teacher or RoomChurch where family worships regularly TOILET HABITS - Children entering the 3s program MUST be toilet trained. CHILD PERSONALITY & HABITSChild's AppetiteHours of sleep Child gets at night INTELLIGENCE & PSYCHOLOGICAL ASSESSMENTS: 3s PRESCHOOL through KINDERGARTEN Applicants ONLYAlthough Calvary Child Development Center does not require testing as part of our admission process, we encourage parents to share any previous assessments with this application to help us better understand your child and assess if our program meets your child's emotional/social, academic, and physical needs.My child has been professionally assessed for:If yes, please explainMy child has been professionally assessed for:If yes, please explain We would like permission to consult with appropriate professional resources concerning the above challenges or assessment. If you grant permission, please email copies of the assessment to Julie Forlenza at jforlenza@calvarycdc.com.Name, Email and Phone of Assessor Has your child been expelled or had serious disciplinary difficulty in school or at another daycare center?If yes, please explain Has your child been withdrawn from any other school or daycare for any reason?If yes, please explain