Expression of Interest in Attending Clarkville School

Expression of Interest in Attending Clarkville School
Child's Name*

First NameLast Name
Date of birth*

MonthDayYear
Date
Gender*

BoyGirlOther
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Year of commencement*

2021202220232024 (children born between 1 January - 1 December 2019)2025
Which term would you like your child to begin school (children must be 5 before starting school)*

Term 1Term 2Term 3Term 4
Year level*
Current school or preschool*
Parent/guardian 1*

First NameLast Name
Relationship to child*
Parent/guardian 2*

First NameLast Name
Relationship to child*
Address (if different from above)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
Email*
example@example.com
Any information you would like us to know
PRIVACY POLICY

Clarkville School maintains a privacy policy. Information provided in this form will be considered confidential and will be used only for the purpose for which it has been provided or a directly related secondary purpose.
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