Clone of WC– 2026-2027 Reg Form (New)

Tilden Preparatory School

1475 N Broadway #200
Walnut Creek, CA 94596
registrationwc@tildenprep.com
www.tildenprep.com
(925) 933-5506
2026-2027 registration form

Remote - NEW STUDENTS
Full-time students attend Tilden as their primary school.

Part-time students have a primary school elsewhere and attend Tilden concurrently.
Status*

Full-TimePart-Time
If your student has attended Tilden previously, please fill out a 2026-27 Returning Students Form.

Student Information
Full Name*

First NameMiddle InitialLast Name
Student's Birthdate*

MonthDayYear
Please upload a recent image of your student for their Tilden profile.*

Cancelof
Student's Email Address*
Student's Cell Phone Number*
Sex/Gender*
Pronouns*

She/Her/HersHe/Him/HisThey/Them/TheirsOther
Student's Birthplace*

CityStateCountry (e.g., USA)
Name of Current/Previous School*
Current Grade Level*
Expected Year of High School Graduation*
In an effort to share what is happening in our community, Tilden takes photos at events and shares these photos through our newsletters, website, social media, etc. If you would NOT like us to use your student's image, please check here:

Please do not use my student's image.
How were you referred to Tilden?*
Please tell us more about how you were referred to Tilden.
Parent/Caregiver Information
Parent/Caregiver 1 - Full Name*
Parent/Caregiver 2 - Full Name
Parent/Caregiver 1 - Address*

Street Address

Street Address Line 2

CityState

Postal / Zip Code
Parent/Caregiver 2 - Address (If Different)

Street Address

Street Address Line 2

CityState

Postal / Zip Code
Parent/Caregiver 1 - Email*
Parent/Caregiver 2 - Email
Parent/Caregiver 1 - Home Phone
Parent/Caregiver 2 - Home Phone
Parent/Caregiver 1 - Work Phone
Parent/Caregiver 2 - Work Phone
Parent/Caregiver 1 - Cell Phone*
Parent/Caregiver 2 - Cell Phone

Academic Accommodation Needs
If your student has an IEP, 504 plan, or Neuropsych report, it is required that we get this information to ensure that we can best meet the needs of each individual student. Please select whether your student has any of the following:*

IEP504 PlanNeuropsych ReportAdditional DocumentationN/A
Please upload the documents marked above, and/or additional documentation you'd like to provide so that we can best meet your student's needs.

Cancelof
Please share any additional information about your student’s learning style, interests, or special circumstances, as well as any suggestions for successful learning strategies that would help us provide the best learning environment for your student.
Behavioral & Disciplinary History

To help us better understand and support each student, please share any relevant history of behavioral or disciplinary concerns your child has experienced in their current or previous school(s). This information will be used to assist us in determining whether we can provide the required support for your child and to allow us to plan appropriate supports and strive to ensure a successful transition.
Has your child had any behavioral or disciplinary incidents, interventions, or support plans (e.g., suspensions, behavior contracts, counseling referrals) in the past? If yes, please describe the circumstances, dates (if known), and any strategies or supports that were effective.

Full-Time Student Course Selection

Families of full-time students should sign up for a scheduling consultation with the Heads of School to determine the best course selection for the year. Scheduling consultations can be arranged via Calendly.

If you know of classes your student would like to take, please list them below.
Course Selection
Transcripts are required for new full-time students. Please upload the most current transcripts and/or grade summaries your student has. If you are unable to upload a transcript at this time, please follow up with our Head of School.

Cancelof
If your student is enrolled elsewhere, has concurrent enrollment been discussed with the school of record's advisor/counselor?

YesNo
Are any of these courses being taken in preparation for a placement exam? (See our Polices & Fees, p. 7)

YesNo
If you would like to meet with our Heads of School, please select "Informational Meeting" to discuss details of your student's enrollment, or "Scheduling Consultation" to discuss details of your student's course selection and schedule!

Part-Time Student Course Selection

If your student is attending Tilden part-time, please list the courses below.

Tutoring Only - Tutoring is to supplement courses taken outside of Tilden. These courses will not show up on the student’s transcript and are not for credit.
Course Selection
OPTIONAL: Upload transcripts and/or grade summaries that may be helpful for scheduling your student.

Cancelof
If your student is enrolled elsewhere, has concurrent enrollment been discussed with the school of record's advisor/counselor?*

YesNo
Are any of these courses being taken in preparation for a placement exam? (See our Polices & Fees, p. 4)

YesNo
If you would like to discuss additional details of your student's enrollment or class schedule, please schedule a meeting with our Assistant Head of School, Eva Allan!

Acknowledgements
Handbook Acknowledgement

I have reviewed the current Parent Student Handbook 2026-27 for Tilden Preparatory School, and I agree to abide by the rules outlined therein.
Parent Name*
Parent Signature*

Powered by Jotform SignClear
Date*

MonthDayYear
Policies & Fees Acknowledgement

I have reviewed the Policies & Fees 2026-27 document for Tilden Preparatory School, and I agree to abide by the policies outlined therein.
Parent Signature*

Powered by Jotform SignClear
Date*

MonthDayYear
Transcript Release

I hereby authorize Tilden Preparatory School to release my/my child’s transcripts to designated schools or institutions upon my written request. I have read and agree to abide by Tilden's Transcript Policy.
- We require two business days for processing transcripts.
- I understand that 1 courtesy transcript is provided for part-time students, and 5 are provided for full-time graduating eighth or twelfth-grade students. All additional transcripts will be billed at $10/transcript.
- For college applications, transcripts can be sent electronically via Parchment. Tilden can provide official transcripts in sealed envelopes, but they must be addressed and mailed by the family.
- Official transcripts are sent directly from Tilden Preparatory School to middle or high schools upon request.
- We require parents to approve their student's transcript before we send it.
- Questions regarding transcripts can be sent to transcriptwc@tildenprep.com.
Parent Signature*

Powered by Jotform SignClear
Date*

MonthDayYear
Student Signature (if over 18)

Powered by Jotform SignClear
Date

MonthDayYear
Group Classes

Though our instruction is primarily one-to-one, parents may choose to coordinate their own small group classes of up to three students per group. Students should have similar learning styles and paces to progress through the material effectively.

Tilden reserves the right to split up students if the teacher feels that they are not working well together, or if one student is struggling to keep pace with another. All students must follow the same class schedule and must coordinate any planned absences in advance to coincide with each other.
I am interested in a group class and have coordinated with another student or students.
Name(s) of other student(s) in the group:
Vacation and Absences

All student absences are billed at the full session rate. We are not able to make courses inactive to accommodate vacations. If a family chooses to schedule a vacation when a student is actively enrolled in a course, students are welcome to attend classes remotely.

To notify us that a student will be absent, parents/caregivers are required to email the student's teacher(s) and school administration before the start of a scheduled class.

Walnut Creek Campus: studentabsenceswc@tildenprep.com

Student may not cancel their own classes. Email only (not a phone call) from a parent/caregiver is required. To find a teacher's email address, log in to the progress reporting system. For instructions, please consult the current Parent Student Handbook 2026-27.

I understand and agree to the Vacations and Absences Policy.
Signature*

Powered by Jotform SignClear
Date*

MonthDayYear
Tilden Community Mailing List

At Tilden, we are always looking for new ways to build relationships between students, parents/caregivers, and families within our community. We are now offering voluntary participation in a Tilden Community Mailing List, community updates sent regularly via email.

As part of these community updates, you and your student's first names would be shared along with those of other participating Tilden families so that you may connect and continue building relationships both in and outside of school.
I would like to participate in the Tilden Community Mailing List, and agree to have my first name, my student's first name, and my email shared as part of these updates.
Please provide an email address for voluntary participation in the Tilden Community Mailing List:

Payment Information

Your student will only be scheduled after we have received both the completed registration form and your scheduling deposit.

Full-Time: $500

Part-Time: $200
- To make a payment by ACH, please use the following link: WALNUT CREEK ONLINE PAYMENT PORTAL.
- To make a payment by VISA credit card, please call our Walnut Creek office at 925-933-5506. Please note that there is a 3.5% service fee.
How did you submit payment?*

I called in to make a VISA payment.I used the Online Payment Portal to make an ACH/e-check payment.
The last four digits of the transaction number are:*
If you call to pay with a VISA credit card, an admin member can provide the transaction number.

Authorization for Release of Information
I/We, parent/cargiver name(s)* , give permission for the Head(s) of School and Director(s) of Tilden Preparatory School to exchange information regarding student name* with the following persons and/or agencies:
Name, Address, Phone/Fax/Email
Email
I hereby release the above persons and/or agencies from any and all legal liability, which may result from the communication of the information referred to above.
Signature*

Powered by Jotform SignClear
Date*

MonthDayYear
Relationship to Student*
Signature

Powered by Jotform SignClear
Date

MonthDayYear
Relationship to Student

Student Emergency Information Form

Please fill out completely and sign where indicated. In a major emergency, it is school policy to retain students at school for their safety. This form will be used by the school staff when students are released to go home.

We ask remote students to submit this form in case they are on campus or if an emergency occurs during virtual learning.
Please download and complete the Student Emergency Information Form below.
Please attach your completed Student Emergency Information Form.*

Cancelof
Should be Empty:

2026-2027 registration form