Applicant Details

Date of Application

Preferred Name

Name

First Names Surname

Date of Birth

Gender

Requested Starting Date

Class Applying For

Previous/Current School

School Name School Contact number

Mothers Details(Only if responsible for child)

Name

First Names Surname

ID/No

Mobile Number

Work/Home

Daytime number

Email

Business Address

Street Address Address Line 2 City Province Postal Code Country

Postal Address

(if different from physical address)

Occupation

Business Name

Business Address

Street Address Address Line 2 City Province Postal Code Country

Fathers Details (Only if responsible for child)

Name

First Names Surname

ID/No

Mobile Number

Work/Home

Daytime number

Email

Physical Address

Street Address Address Line 2 City Province Postal Code Country

Postal Address

(if different from physical address)

Occupation

Business Name

Business Address

Street Address Address Line 2 City Province Postal Code Country

If parents are separated or divorced, please indicate with whom the applicant is living

Background Information

What has brought you to Roseway Waldorf School?

What aspects of Waldorf Education interest you?

Tell us about your pregnancy?

General interests (extra-mural)

Sibling’s names, age, school

Details of birth:

Standard Delivery

Epidural

Caesarean

Forceps

Induced

Jaundice

Transfusion

Any other details about birth:

Breast fed

Yes/No Until what age?

Bottle fed

Yes/No Until what age?

Did your baby easily find a sleeping/waking rhythm or was it fretful / have severe colic / have serious illnesses / need hospitalisation?

At what approximate age did your child:

Walk Talk Get first teeth Begin change of teeth

Has child been separated from his / her mother?

Age Duration

Reason

Background Health & Medical

General

Hearing

Tested

Sight

Tested

Sleep Pattern

Childhood Illnesses

Other

Vaccinations and Ages Given

Chronic illnesses / allergies / disabilities

Please list condition, age diagnosed and medication

Medical Procedures / Operations

Has child ever experienced shock (physical or emotional)?

Family Doctor

Contact Number

Nay other relevant information?

Family Background

How is child’s relationship with his/her?

Siblings

How does your child relate in general to:

What are his/her daily, weekly routines?

How would you describe your family as a whole?

Do you spend regular time together in any activities?

Do you have specific religious beliefs or affiliations?

Does music play a part in your family life?

Are either or both parents absent often / regularly?

What is the attitude in the home to TV, computers, media?

How many hours of media/electronic is your child exposed to?

Is it monitored (length of watching time)?

Other relevant information?

Educational Background

Has child experienced difficulty in any areas/s of his / her schooling?

Yes

No

If yes, of what kind?

Has child achieved any noticeable success in any area(s) of his / her schooling?

What is child’s current attitude toward school?

Has the child repeated a year?

Yes

No

If, yes, Grade(s) / Standard(s) repeated

Reasons for repeating?

Reasons for repeating

Please list duration, age and type of support

Is the child currently on medication for concentration or behavioural difficulties?

Please list any current and past medications used and durations

General Info

Current grade / class?

Has your child:

Please list in which class and at what age

Has your child:

Has child attended crèche?

Please list at what age?

Attitude and behaviour in crèche?

Has child attended Kindergarten?

Please list at what age?

Attitude and behaviour in Kindergarten?

Other relevant information?

Attachments

Two most recent reports?

Drop files here or

Max. file size: 32 MB.

Any of the following assessments? (OT / Educational / Speech / Language / Hearing / Psychological / Other) If so, please attach reports.

Drop files here or

Max. file size: 32 MB.

(where applicable)

Copy of your child’s Birth Certificate

Drop files here or

Max. file size: 32 MB.

Photo of Applicant (passport size, head and shoulders)

Drop files here or

Max. file size: 32 MB.

Parents’ ID Documents

Drop files here or

Max. file size: 32 MB.

Fee clearance certificate from previous school

Drop files here or

Max. file size: 32 MB.

(where applicable)

Utility bill for Proof of Residence

Drop files here or

Max. file size: 32 MB.

Banking details of person responsible for paying fees

Drop files here or

Max. file size: 32 MB.

Proof of income

Drop files here or

Max. file size: 32 MB.

(at least 3 payslips and 3 months bank statements from both parents)

In the case of divorced parents, copy of divorce decree, restraining orders if applicable and Custody Agreement

Drop files here or

Max. file size: 32 MB.

Consent

CAPTCHA

Untitled

Cookie	Duration	Description
cookielawinfo-checkbox-analytics	11 months	This cookie is set by GDPR Cookie Consent plugin. The cookie is used to store the user consent for the cookies in the category "Analytics".
cookielawinfo-checkbox-functional	11 months	The cookie is set by GDPR cookie consent to record the user consent for the cookies in the category "Functional".
cookielawinfo-checkbox-necessary	11 months	This cookie is set by GDPR Cookie Consent plugin. The cookies is used to store the user consent for the cookies in the category "Necessary".
cookielawinfo-checkbox-others	11 months	This cookie is set by GDPR Cookie Consent plugin. The cookie is used to store the user consent for the cookies in the category "Other.
cookielawinfo-checkbox-performance	11 months	This cookie is set by GDPR Cookie Consent plugin. The cookie is used to store the user consent for the cookies in the category "Performance".
viewed_cookie_policy	11 months	The cookie is set by the GDPR Cookie Consent plugin and is used to store whether or not user has consented to the use of cookies. It does not store any personal data.

PROVISIONAL APPLICATION FORM

Applicant Details

Mothers Details(Only if responsible for child)

Fathers Details (Only if responsible for child)

Background Information

Background Health & Medical

Family Background

Educational Background

General Info

Attachments

Consent