Preschool Application | Seneca Academy

Seneca Academy Online Application

Applying Student Name*

Email*

Today’s Date*

Entering Fall of Year*

Student Last Name*

Student First Name*

Student Middle Name

Prefers to Be Called*

Date of Birth*

Gender*

Address Line 1*

Address Line 2

City*

State*

ZIP Code*

Home Phone

Parent 1 Title

Custodial Parent/Guardian 1 Last Name*

Custodial Parent/Guardian 1 First Name*

Custodial Parent/Guardian 1 Relation to Child*

Parent 1 Address

Custodial Parent/Guardian 1 Email*

Email Custodial Parent/Guardian 1

Parent 1 Cell*

Call Parent 1

Parent 1 Employer

Parent 1 Occupation

Parent 2 Title

Parent 2 Last Name

Parent 2 First Name

Parent 2 Relation to Child

Parent 2 Address

Parent 2 Email

Email Parent 2

Parent 2 Cell

Call Parent 2

Parent 2 Employer

Parent 2 Occupation

Sibling 1 Name

Sibling 1 Gender

Sibling 1 Date of Birth

Sibling 1 Current School

Sibling 1 Grade

Sibling 2 Name

Sibling 2 Gender

Sibling 2 Date of Birth

Sibling 2 Current School

Sibling 2 Grade

Sibling 3 Name

Sibling 3 Gender

Sibling 3 Date of Birth

Sibling 3 Current School

Sibling 3 Grade

Sibling 4 Name

Sibling 4 Gender

Sibling 4 Date of Birth

Sibling 4 Current School

Sibling 4 Grade

Returning Seneca Academy Family*

How did you hear about Seneca Academy?*

Do you know any current or former families?

Please list your child’s previous school experience, if any.*

What are some of your child’s favorite activities?*

Does your child separate easily from you?*

Does your child have any special fears?*

How do you discipline your child?*

What do you expect to gain from our program?*

Is there anything else you would like us to know about your child?

Please note that students must turn 3 by September 1, 2021 to be in Preschool 3s classes; 4 by September 1, 2021 to be in Prekindergarten 4s classes; and 4 by June 1, 2021 to be in the prekindergarten 4s Extended Day class.

First Choice*

Second Choice*

By clicking “submit” below, I affirm that I have included all the relevant and necessary information that may affect this student’s educational performance and progress. I understand that this information is to be reviewed only by the Admissions Committee to evaluate Seneca Academy’s ability to appropriately meet the educational needs of this student. Further, I understand and accept that falsification, deception, or omission in any aspect of the application process may result in an immediate review and possible revocaction of admissions.

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