Wait List Application

Note: Century School admits students of any race, color, national origin, or ethnic background.  We are both a licensed preschool with an academic emphasis and a registered nonaccredited private elementary school.  Our year-round program provides 232 school days from 7:30 am to 5:30 pm.  Century School offers each student an individualized ungraded program that does not classify students by age or ability.


Child's Name: Sex:
Date of Birth:  
Street Address: City/State:
Zip Code:  
Mother's Name: Home Phone:
Mother's Employer: Work Phone:
Email Address:  
Father's Name: Home Phone:
Father's Employer: Work Phone:
Email Address:  
How would you like to be contacted?  
Special needs of child (if any):
Names and phone numbers of programs in which child has been enrolled:
I am interested in:
What City?
I'd like enrollment to begin on:
I How did you hear about Century School?