Student Last Name
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Student First Name
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Student Middle Name (if any)
Student Primary Address
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Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Date of Birth
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MM
DD
YYYY
Birthplace
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Student's email address (if applicable)
Sex
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Grade Entering
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6th
7th
8th
9th
10th
11th
12th
School Last Attended
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School type
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School Address
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Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
School Phone
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(###)
###
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School District
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Please list all schools previously attended by the child (name, address, grade(s), year(s)
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Does your child have siblings? Please list names and DOB.
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Primary Parent or Guardian Name
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First Name
Last Name
Primary Parent or Guardian Relationship
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Primary Parent or Guardian Phone
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(###)
###
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Primary Parent or Guardian Address
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Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Primary Parent or Guardian Email
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Primary Parent or Guardian Occupation
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Primary Parent or Guardian Employer
Secondary Parent or Guardian Name
First Name
Last Name
Secondary Parent or Guardian Relationship
Secondary Parent or Guardian Phone
Secondary Parent or Guardian Email
Secondary Parent or Guardian Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Secondary Parent or Guardian Occupation
Secondary Parent or Guardian Employer
Relationship of Parents
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Do any of the following factors apply in your child’s life: absence of father or mother, adoption, in -laws or grandparents in the home, unusual accidents or serious illness, disability, or other?
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Does your child have any limitations which would hinder him/her from normal progress in a regular classroom situation? If so, please explain.
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Has your child ever lived outside of the United States? If so, where, when, and for how long?
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What is the predominant language in your home?
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What languages are spoken by the father?
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What languages are spoken by the mother?
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Please list languages in which your child is proficient.
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What are your child's hobbies?
What sports does your child enjoy playing?
What are your child's special talents?
Parent expectations: What are your expectations for your child's education at City of Knowledge?
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What do you feel are the responsibilities of the school?
Are you interested in being an involved parent? If so, how would you like to contribute?
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Would you like to discuss the option of financial assistance?
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Other (please specify)
Do you have any questions or comments for us?
Application statement: I hereby submit this application for my child and certify that all information provided is correct. I understand that completion of this application does not guarantee enrollment at City of Knowledge school. Please write your name below to indicate your acknowledgement and acceptance of the above.
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