Whidbey Island Waldorf School
PO Box 469,  Clinton, WA  98236

Phone: 360-341-5686
Fax: 360-341-5689

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waldorf@whidbey.com

                                                                                               Attach Photo Here

APPLICATION FOR ENROLLMENT
Please PRINT all information.

For legibility use BLACK ink.

 
DATE: 
CHILD'S Full Name: Birthdate:
Home Address:
Mailing Address (if different than above):
Home Phone: Cell Phone:
E-Mail:
Grade applying for: Date you wish to begin:
If applying for Kindergarten classes, please indicate preference for # of days per week.
( 1 =most preferred; 2=least preferred; X = not willing to consider.  X may affect our ability to offer space.
Nursery:  3-day program
 Kindergarten: _____ 3 or _____ 5 days.

Ethnicity (Optional - for state reports.  Choose one.)  _____Black   _____Asian   _____ American Indian
                   _____ Hispanic  ______White
If parents are divorced, separated or not married, which parent has legal custody?
                           ______ Father     _____ Mother
FATHER'S NAME:
Address (if different than above):
Home Phone: Work Phone: 
E-Mail Address:
MOTHER'S NAME:
Address (if different than above):
Home Phone: Work Phone:
E-Mail Address: 
SIBLINGS AGE SCHOOL
Family Physician: 

Phone:

Emergency Contact:  

Phone:
Parent's Evaluation of Child's Health (include recent changes):

 
Previous Schools attended:
SCHOOL NAME

ADDRESS

 GRADES DATES
                                                                                                                         
Why have you selected this school?

 

 
How did our school come to your attention?

 

 
List your child's recent hobbies, interests, activities:


List your child's strengths:


List your child's weaknesses:


Please offer any additional information that is important for the teacher's full understanding of your child:

 

 
Parent Signatures:
Father: Date:

 
Mother:

 

 Date:

Application Procedure:

  • Please complete the application.

  • Mail or fax the completed application to Whidbey Island Waldorf School.

  • Include your child's photo.

  • Include a $50.00 non-refundable application fee.  This fee is a one-time fee per family and includes siblings.

  • Note:  The acceptance of a child as a student into the school is subject to an interview between parents, child and faculty representatives.