Pinecrest School Application for Admission

-This form is one per student, not one per family.

-An asterisk means it is a required field.

-No space can be left blank. Please type N/A if not applicable.

-Once you click "Submit," the form will no longer be accessible to you and cannot be edited.

-Please contact admissions@pinecrestschool.org with questions.

Applicant Information

Child's First Name *

Child's Last Name *

Child's Date of Birth * +

School Year you are applying for *

Child's Age on September 30th on the year of entry *

Applying to Grade *

Child's Preferred First Name (if different)

Gender *

Child's Home Street Address *

City *

State *

Zip Code *

Home Phone *

Is English your child's primary spoken language? *

What is your child's primary spoken language? *

Does your child currently attend a school or preschool program? *

Child's Current Grade *

School Child Currently Attends *

School Street Address *

City *

State *

Zip Code *

Phone *

How did you hear about Pinecrest School? *

Parent/Guardian Information

-Please type N/A if not applicable.

-Parent/guardian listed as Parent/Guardian 1 will be contacted first should any needs arise.

Parent/Guardian 1 First Name *

Parent/Guardian 1 Last Name *

Relationship *

Parent/Guardian 1 lives at the same address as the child. *

Parent/Guardian 1 Occupation *

Parent/Guardian 1 Street Address, City, State & Zip Code

Parent/Guardian 1 Mobile Phone *

Parent/Guardian 1 Email Address *

Parent/Guardian 2 First Name *

Parent/Guardian 2 Last Name *

Relationship *

Parent/Guardian 2 lives at the same address as the child. *

Parent/Guardian 2 Occupation *

Parent/Guardian 2 Street Address, City, State & Zip Code

Parent/Guardian 2 Mobile Phone *

Parent/Guardian 2 Email Address *

Are Parents/guardians separated or divorced? *

Applicant Lives With (check both if applicable) *

Parent/Guardian 1

Parent/Guardian 2

As the parents/guardians are separated or divorced, who should receive school correspondence? (check both if applicable) *

Parent/Guardian 1

Parent/Guardian 2

Not Applicable

If divorced, who has legal custody of the applicant? (check both if applicable) *

Parent/Guardian 1

Parent/Guardian 2

Not Applicable

Other Information

Please type N/A if not applicable.

If your child has been referred to Child Find or had any educational or psychological testing, please give dates and reasons, and upload supporting documents below. *

Please let us know any medical, personal, or social-emotional events (such as allergies, physical impairments, adoptions, relocations and/or treatment for emotional concerns). Upload supporting documents below *

Any documents relevant to answers in this section can be uploaded here.

Parent/Guardian Comments

Please type N/A if not applicable.

What is your child's attitude towards learning or school? *

Describe how you child is doing in preschool/school. *

What are your child's interests? *

What are some qualities that you appreciate most about your child? *

What are some areas in which support may be needed? *

What qualities about Pinecrest School make you believe that it would be a good place for your child? *

Application Fee

Pinecrest School admits students of any gender, race, color, national and ethnic origin to all the rights, privileges, programs, and activities generally accorded or made available to students in the school.

Pinecrest School does not share families’ contact information with third parties.

The applicant is a former student, a Pinecrest Pavilion or Virtual Pinecrest camper, or the sibling of a current student. *

Yes

No

Application Fee *

Application Fee (non-refundable, non-transferable) - 1 child

Coupon Code

Signature of Person Completing the Form *

clear

Typed Name of person completing the form *

Today's Date * +