School Application

FAIR ACRES COUNTRY DAY SCHOOL REGISTRATION APPLICATON

2021-2022 School Year
Student Information
Child's Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Age as of September, 2021*
Primary Language*
Place of Birth*
Child's Primary Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parents' Information
Parent 1 *

First NameLast Name
Email Address*
Home Phone Number*

Area CodePhone Number
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Cell Phone Number*

Area CodePhone Number
Work Phone Number*

Area CodePhone Number
Parent 1 Work Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent 2*

First NameLast Name
Email Address*
Home Phone Number*

Area CodePhone Number
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Cell Phone Number*

Area CodePhone Number
Work Phone Number*

Area CodePhone Number
Parent 2 Work Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Contacts

In the event parent cannot be reached
Emergency Contact #1*
Phone Number*

Area CodePhone Number
Relationship*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Contact #2*
Phone Number*

Area CodePhone Number
Relationship*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Child's Physician*
Phone Number*

Area CodePhone Number
Known allergies/medical conditions*
Identifying Information
Eye Color*
Hair Color*
Gender*
Race*
Height*
Weight*
Identifying Marks*
School Programs
Select the program and days for which you're applying*

3-Year-Old (2-day program = Tu/Th; 3-day program = M/W/F; 5-day program = M-F)Pre-K (select a minimum of 3 days, any combination)Kindergarten (full-time, 5 days) - WAITLISTED
Select Days*

MondayTuesdayWednesdayThursdayFriday
3-year-old pick-up time selection (Extended Day Option = $275/month)

3:30 PMExtended Day until 5 PM
3-year-old pick-up time selection (Extended Day Options = $275/month)

Extended Day until 3:30 PMExtended Day until 5 PM
4-year-old pick-up time selection (Extended Day Option = $275/month)

3:30 PMExtended Day until 5 PM
Kindergarten pick-up time selection (Extended Day Option = $275/month)

3 PMExtended Day until 5 PM
All Families: a $75.00 registration fee is due with your application. This payment holds your child’s place on our roster and is non-refundable.

New Families: a $200 non-refundable deposit is due with your application. This deposit will be applied to your September tuition.

All Kindergarten Families: a $200 non-refundable deposit is due with your application. This deposit will be applied to your September tuition.

Please mail checks to:

Fair Acres Country Day School & Summer Camp
35 Fair Acres Drive
Marstons Mills, MA 02648

Or you may call us at (508) 420-3288 to make a credit card payment.
All Families: a $75.00 registration fee is due with your application. This payment holds your child’s place on our roster and is non-refundable.

New Families: a $200 non-refundable deposit is due with your application. This deposit will be applied to your September tuition.

All Kindergarten Families: a $200 non-refundable deposit is due with your application. This deposit will be applied to your September tuition.

Please mail checks to:

Fair Acres Country Day School & Summer Camp
35 Fair Acres Drive
Marstons Mills, MA 02648

Or you may call us at (508) 420-3288 to make a credit card payment.
View the 2021-2022 Dates & Rates here:
Name of person completing this application*

First NameLast Name
Signature*

Clear
Signature of person completing this application
Should be Empty:

FAIR ACRES COUNTRY DAY SCHOOL REGISTRATION APPLICATON

Student Information

Parents' Information

Emergency Contacts

School Programs