First Name *

Last Name *

Email Address *

Phone *

Street Address *

Apartment, suite, etc

City *

State/Province *

ZIP / Postal Code *

Emergency Contact Name *

Emergency Contact Phone  *

Child First Name *

Child Last Name *

Birthday  *

Child’s Grade (Estimate for 2024-2025) *

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List All Additional Children's Birthday0 / 500

List All Additional Child’s Grade (Estimate for 2024-2025)0 / 500

Does your child have any allergies? Please describe. *0 / 500

Does your child have any diagnosed or suspected special needs? *0 / 500

Does your child need any medication? Please describe. *0 / 500

Describe your child(ren). What are their interests? Do they have hobbies? If known, what is/are their temperament(s)? *0 / 500

What is your philosophy on discipline? *0 / 500

Is there anything you would like to tell us about your child's schooling background?  *0 / 500

What do you hope to achieve by providing your child with a classic education? *0 / 500

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