Application for Admission Name of Applicant* First Last Academic Year Child's Birthdate* Month Day Year Gender Female Male Have any family members previously attended Rose Hall? Name you would like your child to use at school Gender and age of siblings Placement preference is given to siblings of current students and alumniThis Application is for the following programLittle Explorers Parent/ChildChild must be 13-23 months old by Sept 1. Check one or both. Tuesday 8:45 – 10:15 AM Friday 8:45 – 10:15 AM Toddler Program (24-36 mo)Child must be 2 years old by Sept 1 M/W/F 8:30-10:30 am T/Th 8:30-10:30 am If your preferred Toddler class time is not available, would you consider the alternate time?* Yes No If your preferred Preschool class time is not available, would you consider the alternate time?* Yes No Preschool Program (3-6 years)Child must be 3 years old by Sept 1 M-F 8:30-11:30 am M-F 12:30-3:30 pm Has your child previously attended another preschool? Yes No When and where? How did you learn about Rose Hall?Parent / Guardian 1 InformationName of Parent or Guardian* First Last Home Address* Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Home PhoneCell PhoneEmail Occupation Name of Firm Business Address Business PhoneEducational Background Hobbies, other interests Parent / Guardian 2 InformationName of Parent or Guardian First Last Home Address Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Home PhoneCell PhoneEmail Occupation Name of Firm Business Address Business PhoneEducational Background Hobbies, other interests Application FeeA $100.00 non-refundable fee is required with this application. Price: CommentsThis field is for validation purposes and should be left unchanged. All children, regardless of race, gender, ethnicity, religion and/or national origin, are welcome to attend Rose Hall provided the program selected is appropriate for the child and space is available.