Student's First and Last Name

Student's DOB (MM/DD/YYYY)

Gender Gender Male Female

What school day would you like to enroll your child for? What school day would you like to enroll your child for? Preschool K-3 Enrichment

Parent or Guardian's First and Last Name

Address

City

State

Zip Code

Email Address

What are his/her strengths both inside and outside of the classroom?

Where does he/she struggle?

Where does he/she find joy?

How did you hear about the Day Academy? How did you hear about the Day Academy? Instagram Website Friend

If you have another child to enroll, please type their name here: (First & Last Name)

Gender Gender Male Female

Student's DOB

What school days would you like to enroll your child for? What school days would you like to enroll your child for? Preschool K-3 Enrichment

What are his/her strengths both inside and outside of the classroom?

Where does he/she struggle?

Where does he/she find joy?

If you have another child to enroll, please type their name here: (First & Last Name)

Gender Gender Male Female

Student's DOB

What school days would you like to enroll your child for? What school days would you like to enroll your child for? Preschool K-3 Enrichment

What are his/her strengths both inside and outside of the classroom?

Where does he/she struggle?

Where does he/she find joy?