Cambridge International Preschool at Buckhead
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Cambridge International School Admissions Form
*
Indicates required field
Child's Name
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First
Last
First, Last
Preferred Name (nickname)
*
Date of Birth
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Gender
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Address
*
Line 1
Line 2
City
State
Zip Code
Country
Language Spoken at Home
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First, Secondary
Child lives with (drop down to select)
*
Both Parents
Mother
Father
Other (please elaborate)
My child's doctor (name, address, telephone #)
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My child has the following allergies/health conditions
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1st Parent/Guardian Name
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First
Last
First, Last
Preferred Email
*
Phone Number
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Emergency Contact #
Occupation
*
Employer
*
Work Phone Number
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Address (if different than child)
*
Line 1
Line 2
City
State
Zip Code
Country
2nd Parent/Guardian Name
*
First
Last
First, Last
Preferred Email
*
Phone Number
*
Emergency Contact #
Occupation
*
Employer
*
Work Phone Number
*
Work Phone
Home Address (if different than child)
*
Line 1
Line 2
City
State
Zip Code
Country
My child may be released to the following person/people (ID must match this information and email written to Director prior to release)
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Authorized Pickup - Name
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First, Last
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Mobile Telephone Number
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Relationship to Child
*
Authorized Pickup - Name
*
First
Last
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Mobile Telephone Number
*
By signing below, I hereby certify that the information on this application is complete and correct.
Parent/Guardian (electronic signature)
*
First
Last
First, Last Name
Date of Electronic Signature
*
MM-DD-YYYY
Submit
Home
About Us
Core Values
Individualized Curriculum
Approach to Learning
Multicultural Learning
Spanish Program
Admissions
Touring Cambridge
Tour Questionnaire
Parent Portal
Parent Documents
Parent Information
Our School Photos