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Rosebud Playschool Application
Please submit your $25 application fee along with this form via Venmo or Paypal
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Email
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Your email
General
Today's Date
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Child's Full Name
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Your answer
Child's preferred name
Your answer
Child's birthdate
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Child's gender
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Your answer
Your name
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Your answer
Phone number
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Your answer
Email
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Your answer
Address
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Your answer
Is there another parent and/or another household? If yes, please include Name, phone number, email, address, etc.
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Your answer
Does your child have siblings? Do they live in the same household? What are their names/ages/genders?
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Your answer
What drew you to this program? What are your goals for your child and/or family while participating in this program (social, emotional, intellectual, spiritual, etc)?
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Your answer
Do you have any familiarity with Waldorf Education? Describe.
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Your answer
How comfortable are you with your child being outside in all types of weather? Taking risks like climbing trees, being around open flames?
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Your answer
Waldorf early childhood programs work carefully to support the development of the child’s physical and spiritual bodies. During these first critical years of development, children need human interaction, imaginative play and lots of physical movement. There is substantial and compelling research demonstrating the negative impact of electronic media upon the neurological development of the child. Therefore, it is requested that the families within this program agree to strongly limit their child’s exposure to screen media. We ask that you refrain from exposing your child to any television, movie or computer screens during our school week: from Monday evening until Thursday morning. When a child watches television the evening or morning before attending school, they have a difficult time listening to a story, watching a puppet show, or engaging freely in play because their mind is already filled with the pictures they saw on a screen.
Is this something your family can get on board with?
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Your answer
Please briefly describe your child’s experience
and
tendencies in the following areas
Interaction with peers
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Your answer
Interaction with adults
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Your answer
Ability to understand & follow spoken directions
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Your answer
Independence in self-help skills (dressing, toileting, shoes, etc)
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Your answer
Previous group experiences
(enter n/a if not
applicable
)
Has your child been in any group settings with other children their age, with or without parents? Please describe.
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Your answer
Have you left your child with a babysitter or dropped your child off at group care settings such as preschool, daycare, etc? Please describe. How did the good-byes go?
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Your answer
What were some positive aspects of programs your child has attended?
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Your answer
Negative aspects or challenges?
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Your answer
Do you have any concerns about your child from past daycare, school, or group experience? If so, please describe.
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Your answer
Your Child
What are your child’s favorite toys and activities? Please describe your child’s special interests and joys. What is your child naturally drawn toward? What excites your child?
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Your answer
What does your child find challenging? What frustrates your child or upsets him/her? When your child is upset, what helps to calm him/her down?
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Your answer
What do you see as the biggest challenges/struggles that your child is currently working on?
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Your answer
Does your child have any special needs or learning differences, or diagnosed or undiagnosed emotional or cognitive challenges? If so, please describe/explain. Please note any evaluations or therapies your child has received or is currently receiving.
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Your answer
Describe any important experiences or significant changes your child may have had in the past year or may experience in the coming school year (moving, new baby, weaning, etc)
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Your answer
Does your child have any allergies or food intolerances?
Your answer
Is there anything else you would like to share with us about yourself, your family, or your child?
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Your answer
What enrollment type are you applying for?
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4 days (Monday-Thursday)
2 days (Monday/Tuesday)
2 days (Wednesday/Thursday)
2 days (no preference on days of the week)
Are you interested in applying for a work-trade agreement in return for partial tuition remission? What type of service would you offer and what it your professional/personal experience in that realm?
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Your answer
How will you be paying the application fee of $25?
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Venmo @Zoe-Rothfuss
Paypal @ZoeRothfuss
A copy of your responses will be emailed to the address you provided.
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