Baker Day School Interest Form

Baker Day School Interest Form

Student information
Student's Name

First NameMiddle NameLast NameSuffix
Student's Address

Street Address

Street Address Line 2

CityState

Zip Code
Student's Bithday

MonthDayYear
Grade Level
Student's Current School
Student's Phone (If applicable)
Please enter a valid phone number.Format: (000) 000-0000.
Student's Email (If applicable)
example@example.com

Parent/Guardian Information
Parent/Guardian #1

PrefixFirst NameMiddle NameLast NameSuffix
Parent/Guardian #1 Address

Street Address

Street Address Line 2

CityState

Zip Code
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Relationship to Student
Is there a second parent or legal guardian?

Parent/Guardian #2 Information
Name

PrefixFirst NameLast NameSuffix
Address (if different)

Street Address

Street Address Line 2

CityState

Zip Code
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Relationship to Student

Academic History
Please indicate the student's previous academic environments (may choose multiple):

Other
Please describe what you hope your student would gain from attending The Baker Day School of TNPA
Does your student currently receive academic accommodations or support services?
Would you like to discuss this before your visit?

Student Artistic Interests and Background
Please indicate your student's area(s) of interest:

Other
Does your student have prior theatre, music, dance, or performance experience?
Please Explain

Next Steps
What would you like to schedule?
How Did You Hear About Us?
Please explain:
Please list any additional questions or concerns!
Please verify that you are human
Should be Empty: