Application – Westbury Friends School

Child 1 Information
The below fields request information about the child applying to Westbury Friends School.
Name*
First Middle Last
Preferred Name
Gender*
- Male
- Female
Date of Birth*
Please upload a copy of your child's birth certificate.
Accepted file types: jpg, gif, png, pdf.
Current Grade*
School District*
District Number*
Name of present school*
School Phone*
Start Date*
End Date*
Siblings
Name of Sibling Date of Birth School
Child lives with:*
Relationship:*
Would you like to submit an application for a second child?*
- Yes
- No

Child 2 Information
The below fields request information about the child applying to Westbury Friends School.
Name*
First Middle Last
Preferred Name
Gender*
- Male
- Female
Date of Birth*
Please upload a copy of your child's birth certificate.
Accepted file types: jpg, gif, png, pdf.
Current Grade*
School District*
District Number*
Name of present school*
School Phone*
Start Date*
End Date*
Child lives with:*
Relationship:*

Parent/Legal Guardian Information
The below fields request information about the child's parent or legal guardian.
Name*
First Last
Home Address*
Street Address Address Line 2 City State ZIP Code
Email Address*
Home Phone*
Cell Phone
Occupation/Title*
Business Name
Business Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Business Phone
Stepparent Name (If Applicable)
First Last
Does this child have a second parent/legal guardian?*
- Yes
- No

Second Parent/Legal Guardian Information
The below fields request information about the child's second parent or legal guardian.
Name
First Last
Home Address*
Street Address Address Line 2 City State ZIP Code
Email Address*
Home Phone*
Cell Phone
Occupation/Title*
Business Name
Business Address
Street Address Address Line 2 City State ZIP Code
Business Phone
Stepparent Name (If Applicable)
First Last

Child 2 Application Information
The below fields request information specific to your child's application for a Westbury Friends School program.
Applying for grade:*
Have you ever applied to Westbury Friends School for this child?*
- Yes
- No
Year*
Please enter a value between 1900 and 2100.
Has your child ever been recommended for services?*
- Yes
- No
Does your child have an IEP?*
- Yes
- No
Is your child currently receiving services?*
- Yes
- No
Please tell us about interests, hobbies, and/or talents you have observed in your child.*
Please comment on reasons you wish to have your child attend Westbury Friends School.*

Application Signature
Please sign below to indicate that the information you're submitting to Westbury Friends School is accurate.
Signature*
I understand that this application and procedure will in no way obligate us to the school or the school to us.

Application Fee
Please use the form below to submit your application fee. Your information will be transmitted securely.
Application Fee
Price: $60.00
This page is unsecured. Do not enter a real credit card number! Use this field only for testing purposes.
Credit Card

American Express
Discover
MasterCard
Visa
Card Number Expiration Date Security Code Cardholder Name
Phone
This field is for validation purposes and should be left unchanged.

Westbury Friends School