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TAS Application for Enrollment
Date you wish student enrolled, Please give month and year.
Date of Application
Child's Name: Last, First or Nickname, Middle
Birthdate
Age in Years and Months
Gender

Address: Street, City, State, & Zip
Home Phone
Cell Phone
Email Address
Present School Grade
Present School
GRADE UPON ENTERING: EARLY CHILDHOOD










GRADE UPON ENTERING: ELEMENTARY




GRADE UPON ENTERING: MIDDLE SCHOOL


AFTERCARE: Please indicate days you will need after school supervision:




Father's Name
Father's Occupation
Father's Business Name
Father's Business Phone
Father's Cell Phone
Mother's Name
Mother's Occupation
Mother's Business Name
Mother's Business Phone
Mother's Cell Phone
Applicant resides with:



If "Other" is chosen above, please explain.
Your Name:
Your Email:

To validate your submission, please type the answer to the following question:

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Download Full Application

The Anthony School is a non-profit organization. It does not discriminate on the basis of race, religion, ethnic origin, gender, mental and physical disability, or any other consideration unrelated to education.