TIS EARLY ENROLLMENT FORM


Student Information
Name of Student *
Applying For Grade
(starting 2012)
Student's Gender *
 Male 
 Female 
Student's Date of Birth *

MM		 /
DD		 /
YYYY
Current Grade
Name of Current School
Location of Current School
(city, neighborhood)

Parent / Guardian Information
Name of Parent/Guardian *
Address *

Street Address

Address Line 2

City
State / Province / Region

Postal / Zip Code
Country
Home Phone *

###		 -
###		 -
####
Mobile Phone

###		 -
###		 -
####
Email *
How did you hear about
The Intergenerational School?

(check all that apply) *
 Friend / Family 
 News / Media 
 Fair / Festival 
 Online / Research 
 Other 
Other:
Which is the primary reason you would choose to send your child to TIS? *
 Safety & security 
 Convenient Location 
 High-quality academics 
 Siblings / family attend 
Your Next Step *
 I have received and will the complete enrollment packet 
 I need an enrollment packet, please contact me with it 
 I would like to attend an information session 
Comments / Questions