Preschool Application - Seneca Academy

We recommend filling out this application on a non-mobile device, such as a laptop or a desktop computer. If you have not received a response more than two business days after your application submission, please email the Director of Admissions.

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 us?*

Current/Former Families Known

School Experience*

Favorite Activities*

Separates Easily?*

Special Fears*

Discipline*

Goals*

Miscellany

First Choice*

Second Choice*