* = Required Field General Information
*Applicant's Name:	Gender:
	* Male  Female
*Date of Birth:
/ /
Name of Parent(s)/Guardian(s):
Relationship:
*Address:
*Applicant lives with:
Father *Name: Occupation: Employer: Business Address: *Phone: Email:	Mother *Name: Occupation: Employer: Business Address: *Phone: Email:
Please note any Special living circumstances/arrangements:
Student Profile
Schools attended, including preschool or homecare
Dates:    Grades:    School Name:
Dates:    Grades:    School Name:
Dates:    Grades:    School Name:
Dates:    Grades:    School Name:
Is student shy? Yes No Overactive? Yes No Bites Nails? Yes No Sucks thumb? Yes No Excessive fears? Yes No Temper Tantrums? Yes No Do they like school? Yes No Plays well with others? Yes No Eats Breakfast? Yes No Will take a nap? Yes No Time: Regular bed-time? PM Rising Time: AM
Knows alphabets? Yes No Some	Knows numbers? Yes No Some
Knows shapes? Yes No Some	Knows colors? Yes No Some
Favorite Color:
Additional Information
Which two factors most influenced you to aply to SFP (please check only two):
Location	SFP academic reputation
Strength of Early Reader programs	Displeasure with current childcare provider
Recommendation of SFP families	Other Reasons