APPLy to join THE Shire SCHOOL

Child's Name *

First Name

Last Name

Date of Birth *

MM

DD

YYYY

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Parent/Guardian One Contact *

First Name

Last Name

Phone *

(###)

###

####

Parent/Guardian Two Contact

First Name

Last Name

Phone

(###)

###

####

Child is presently living with

Parent/Guardian One

Parent/Guardian Two

Both

Dietary Restrictions/Allergies *

No

Yes (Please comment in "Additional Info")

Add me to your mailing list

Yes

No

Registration Fee *

I understand there will be a $250 registration fee for applying to The Shire School