Facility #304370649

For your application to be accepted, please include the following items:

1. Application completely filled out and signed.
2. Application Fee of $50.00 (non-refundable)
3. Material Fee of $300.00 (non-refundable)

Please prepare to upload the following documents:

• Copy of Birth Certificate

• Copy of Immunization Record (per California Health Code)Please note: 

Please note:  Student must be completely potty trained at the time of enrollment.

Complete the registration form below. Required fields marked with an asterisk *

Student Background Information

Sibling Information

Does the applicant take any prescribed medication(s) or need any special medical attention?

Vaccine Verification

Please clearly list the dates each for vaccine given. All requirements must be met for student to attend school ( This form must be accompanied with corresponding vaccination evidence in English).

Polio (Four Doses Required):

DTap / Tdap - Diptheria, Tetanus, Pertussis( Four Doses Required for ages up through 11 years of age.)

MMR - Measles, Mumbs, Rubella ( Two Doses Required)

Hepatitus B ( Three Doses)

Varicella - Chicken Pox (One Dose Required) *If student had disease, the vaccine is not required, but must be verified by medical doctor.

Parent Information

File Uploads

Agreement

• If my child is accepted, I understand that I must pay the material fee of $50 at the time of enrollment. 
• I understand the material fee of $300 and application fee of $50 are Non-Refundable. 
• I understand I MUST read the Tuition Policy, The Parent Handbook, and agree the enrollment of my child constitutes full acceptance of the policies.
• I certify the information given above is complete and accurate. I understand the failure to disclose information about the applicant's medical or emotional history may affect the school's admissions decision and the school reserves the right to reverse an admissions decision, even after acceptance and enrollment, at the school's sole discretion.