Charlotte Country Day School

Thank you for your interest in Charlotte Country Day School.

I would like to:

About the Student

Note: Please enter a preferred name even if it is the same as the first name.

Name

First

Middle

Last

Suffix

Preferred Name

Date of Birth

mm/dd/yyyy

Charlotte Country Day School is committed to diversity, equity and inclusion.

Gender

Ethnicity

Current Grade

Interested in Grade

For the Fall of

Current School

About the Parent/Guardian

Name

Title

First

Middle

Last

Suffix

Preferred Name

Relationship to Student

Primary Phone (xxx-xxx-xxxx)

Type

Number

Secondary Phone (xxx-xxx-xxxx)

Type

Number

Email

Mailing Address

Is there a second parent or legal guardian in this household?

Yes No

Name

Title

First

Middle

Last

Suffix

Preferred Name

Relationship to Student

Primary Phone (xxx-xxx-xxxx)

Type

Number

Secondary Phone (xxx-xxx-xxxx)

Type

Number

Email

Do you have any other students interested in Country Day?

Yes No

How many siblings, if any, does the applicant have?

Sibling 1

Name

First

Middle

Last

Suffix

Preferred Name

Relationship to Applicant

Date of Birth

mm/dd/yyyy

Sibling 2

Name

First

Middle

Last

Suffix

Preferred Name

Relationship to Applicant

Date of Birth

mm/dd/yyyy

Does this sibling currently attend Charlotte Country Day School?

Yes No

Grade

Current School

Sibling 3

Name

First

Middle

Last

Suffix

Preferred Name

Relationship to Applicant

Date of Birth

mm/dd/yyyy

Does this sibling currently attend Charlotte Country Day School?

Yes No

Grade

Current School

Sibling 4

Name

First

Middle

Last

Suffix

Preferred Name

Relationship to Applicant

Date of Birth

mm/dd/yyyy

Does this sibling currently attend Charlotte Country Day School?

Yes No

Grade

Current School

Sibling 5

Name

First

Middle

Last

Suffix

Preferred Name

Relationship to Applicant

Date of Birth

mm/dd/yyyy

Does this sibling currently attend Charlotte Country Day School?

Yes No

Grade

Current School

Sibling 6

Name

First

Middle

Last

Suffix

Preferred Name

Relationship to Applicant

Date of Birth

mm/dd/yyyy

Does this sibling currently attend Charlotte Country Day School?

Yes No

Grade

Current School

How did you hear about Charlotte Country Day School?

Please specify