THE WALDORF INSTITUTE OF SOUTHERN CALIFORNIA

THE WALDORF INSTITUTE OF SOUTHERN CALIFORNIA
APPLICATION FORM
LOS ANGELES: 17100 SUPERIOR ST. NORTHRIDGE, CA 91325 PHONE: 818-349-6272SAN DIEGO: 4135 54TH PLACE, SAN DIEGO, CA 91305 PHONE: 760-451-2139
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
E Mail
example@example.com
Previous Name if applicable
Preferred Pronouns
Partner's Name if applicable
Child(ren)'s Name(s)
Do you intend to apply for tuition adjustment?

YesNo
Have you attended classes at WISC or another Waldorf teacher education institute?

YesNo
Please specify institute, date, and courses
List education to date in chronological order. Please email a copy of relevant transcripts directly to office@waldorfteaching.org. Unofficial transcripts are acceptable.
High School
City, State, Country
College/University/other
City, State, Country
Degree - Major and Year of Graduation
Other/Higher Education
City, State, Country
Other Education
City, State, Country
EMPLOYMENT & ACTIVITIES HISTORY
Current Occupation
Type of Work
Employer
Location
(from to)
PREVIOUS EMPLOYMENT
COMMUNITY AND VOLUNTEER ACTIVITIES (Please list briefly) Organization, Activities
List any additional information you feel would support your application, such as languages spoken, musical instruments played, special interests
Do you hold a teaching certificate? Please specify
Type
State
Do you have experience as an educator in a professional or volunteer capacity? Please describe
PREVIOUS READING
Please list books about Waldorf education which you have read
Please list books by Rudolf Steiner which you have read
Have you read other books about Anthroposophy?
AUTOBIOGRAPHY
On a separate sheet of paper, please give us a brief outline of your biography (a page or less
STATEMENT OF PURPOSE
On a separate sheet of paper, please describe what led to your decision to apply to WISC. Include your goals at this time, particular areas of interest and questions you may have. Briefly comment on your strengths and weaknesses with regard to this course of study.
LETTERS OF REFERENCE
Please request letters of reference from two people who have worked closely with you or know you well. Names and emails of the people who will be sending references:
1)
2)
The above information is correct and complete to the best of my knowledge. I understand that all materials and credentials submitted by me and on my behalf become the property of WISC and will not be released to anyone except WISC personnel.
Please submit a non-refundable, non-transferable fee of $90.00 with this application. Be sure to include autobiography, statement of purpose and medical form. Letters of reference and transcripts may be mailed separately to office@waldorfteaching.org.

Click on donate online to make payment. We will make sure it is applied to your registration.

https://www.waldorfteaching.org/donate

or mail check to:

WISC

17100 Superior St.

Northridge, CA 91325

The Waldorf Institute of Southern California does not discriminate on the basis of sex, race, color, religious belief, age, national origin, ancestry, or handicap in admission to the Institute, in financial aid programs in educational programs and policies
Medical Form
Person to contact in an emergency*
Relationship*
Address
Cell Phone
Your Date of Birth

MonthDayYear
Date
Name of your physician
Address
Phone
Are you currently being treated by a physician for any ongoing condition?
If so, are there activities you cannot participate in?
Are you currently taking any medication?
Is there anything else we should know about your medical history?
Today's Date

MonthDayYear
Date
CHECK LIST
Please send us by email at office@waldorfteaching.org or regular mail:

1. Brief Biography of one page or less. This may be typed or carefully handwritten.

2. Statement of Purpose. Typed or handwritten, one page or less.

3. Transcripts. Unofficial transcripts are fine.

4. Letters of Reference. These can be sent separately or together with the application.

Thank you.
Should be Empty:

THE WALDORF INSTITUTE OF SOUTHERN CALIFORNIA

APPLICATION FORM

EMPLOYMENT & ACTIVITIES HISTORY

PREVIOUS READING

AUTOBIOGRAPHY

STATEMENT OF PURPOSE

LETTERS OF REFERENCE

Medical Form

CHECK LIST