Pre-Enrollment Questionnaire

Pre-Enrollment
Questionnaire

IMPORTANT! Please verify that all information is correct before clicking the “Submit” button. If you have any questions, please contact The Anchored School at 908-326-6919 or info@theanchoredschool.org. Thank you!

* Indicates required field

Your Full Name *

First

Last

Email Address *

Confirm Email

Daytime Phone *

Evening Phone *

Mother's Name *

First

Last

Father's Name *

First

Last

Child's Name *

First

Last

Street Address 1 *

Street Address 2

City *

State *

5-Digit Zip Code *

Child's Birthday/Due Date *

Name(s) of additional children you want to enroll (please separate names with commas)

When are you interested in starting classes? *

Program of Interest *

Is your child currently enrolled in a school?* *

Questions/Comments