Application Form.

Child's Name *

First Name

Last Name

Child's Date of Birth *

MM

DD

YYYY

Parent/Guardian's Name *

First Name

Last Name

Phone *

(###)

###

####

Which programs would you be interested in? *

Spring Semester 2025

School year 2024-2025

School year 2025-2026

Which days would you be interested in? *

A minimum of two (2) back to back days are required for children who are new to separation/drop off.

Full week

Monday

Tuesday

Wednesday

Thursday

Friday

How often are you available to participate in parent-involvement activities? *

Weekly

Monthly

Maplewood Outside School is a school for students who fall within a typical range of academic and social styles and who do not present significant and persistent learning differences or behavioral or emotional challenges. Applicants for admission with a diagnosed learning disability and/or a current IEP or 504 Plan will be evaluated on a case by case basis. In determining what learners we can serve, we recognize our capabilities and limitations and our wish to meet each student's needs with integrity. *

I have read and understand this statement

Our school day ends at 12. Are you interested in extended day until 1:30?

Yes

No thanks