The Albrook School

361 Somerville Road, Basking Ridge, NJ 07920

Phone: (908) 580-0661    Fax (908) 580-0785

 

Application for Admission
 

Applicant's Name:__________________________________________

Birthdate: _______

Boy: ___

Girl: ___

Address: _____________________________________________________________

Phone:  _____________

(Street)

 (Town)

                (Zip)     

 

Father's Name:__________________________________________

Home Address (if different): _____________________________________________________________________

Home Phone:    _________________________________________

 Cell Phone:                                                         

Name Employer: ________________________________________

 Business Phone:                                                 

 Address: ____________________________________________

 E-mail: _______________________________

___________________________________________________

 Position: _____________________________

Can Father be reached at work? ___________

Is Father away from home for long periods of time?______________

Mother's Name: _________________________________________

Address:  (if different):__________________________________________________________________________
Home Phone:                                                                                                       Cell Phone:                                                      
Name Employer _________________________________________  Business Phone:                                             
Address:                                                                                  E-mail: ______________________________
                                                                Position:                                                   

Can mother be reached at work? __________

Is Mother away from home for long periods of time? ____________

Does anyone care for the child other than the parents for long periods of time? ______________________________

Previous School Experience:  _____________________________________________________________________

                                                                                                                                                                

Sibling's Name:                                                  Age:             Gender: ___ School:                              
Sibling's Name:                                                   Age:             Gender: ___ School:                              
Sibling's Name:                                                  Age:            Gender: ___ School:                               

Does the child have any physical or visual problems? _______________________________________________

Is the child under medical care? __________________

Is the child on any medication? ___________________

Will you require before or after/school care? _________

Anticipated Hours: ____________________________

*Children applying for Stepping Stones must be 2 years old by September 15 and children applying for the Pre-school program must be 3 years old by September 15.
*Children must be completely toilet trained for all programs with exception of Stepping Stone.

Additional information which may assist the teacher:  (Please use reverse side)

Application Fee - $60.00 Non-Refundable   ______ I would like to tour the school ________ I have toured ________
How did you hear about Albrook?  ___friend   ___newspaper   ___ realtor   ___website  ___other                    (date)

                                                                                                                                                  

Signature: __________________________________________________________

Date: ______________