Application for Admission | The School in Rose Valley

Date*

Applicant Information

Applicant's last name*

Last

First name*

First

Prefers to be called

Gender

Date of birth*

Desired entry date*

Current school or program (if applicable)

Schools Previously Attended

School

Date

School

Date

Grade Applying For*

The minimum age for preschool at SRV is 2 years 7 months when school starts in September. Students must be able to use the bathroom independently.

Youngest Group-(2 years 7 months – approximately 4 years)

Preschool Circle-(approximately 3 years 6 months – 5 years)

Kindergarten-(age 5 on September 1)

Preschool Groups

Please select your enrollment preference from the two preschool groups listed below:

5 Days (M-F)

Full
Half

3 Days (M, W, F)

Full
Half

2 Days (T, Th)

Full
Half

3 Full Days (M, T, W) & 2 Half Days (Th, F)

3 Full / 2 Half Days

Grades

(age 5 on September 1)

What are your expectations of progressive, independent schooling for your child?*

What are your educational goals for your child in the coming year(s)?*

Please provide any additional information that you believe will help us get to know and understand your child.

Tuition Assistance information may be accessed from the SRV website, theschoolinrosevalley.org.

Please check this box if you plan on applying for tuition assistance.

Family Information

Parent/Guardian 1*

First Last

Parent/Guardian 2

First Last

Address*

Street Address Address Line 2 City State ZIP Code

Address

Street Address Address Line 2 City State ZIP Code

Home Phone*

Mobile Phone*

Home Phone

Mobile Phone

Email*

Email

Occupation*

Occupation

Employer*

Employer

Work Phone*

Work Phone

Do parents/guardians reside in the same household?*

If parents/guardians do not reside in the same household, please describe arrangements (only or primarily with one parent/guardian, divides time between both parents/guardians, or other).

Who has legal responsibility for the applicant?*

Who is responsible for tuition?*

Applicant’s Siblings

Name

First Last

Date of birth

School

Name

First Last

Date of birth

School

Optional Information Requested

Applicant’s ethnicity

Primary language

Parent/Guardian Confirmation*

I / We understand that the non-refundable application fee of $50 per family is required in order for this application to be considered complete.
I / We give permission for SRV to contact or visit the applicant’s present school if additional information is required.

Payments can be made via check or by clicking the payments link in the upper right hand corner of this page.

Return $50 fee to The School in Rose Valley 20 School Lane • Rose Valley, PA 19063 • admissions@theschoolinrosevalley.org

Notice of Nondiscriminatory Policy as to Students: The School in Rose Valley admits students of any race, color, national, and ethnic origin to all the rights, privileges, programs and activities generally accorded or made available to the students at the school. It does not discriminate on the basis of race, color, national, and ethnic origin in administration of its educational policies, admissions policies, tuition assistance program, and other school-administered programs.

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