Wildflower Enrollment Interest Form
Thank you for your interest in Wildflower Open Classroom! Please fill out this interest form to add your child to our list for future enrollment at Wildflower. If you are wanting to enroll more than one child, please fill out the form for each child. Feel free to contact the office with any questions at (530) 892-1676.
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Email *
I am interested in enrolling my child for the *
Student's (Legal) Last Name *
Student's (Legal) First Name *
1st Parent/Guardian's (Legal) Last Name *
1st Parent/Guardian's (Legal) First Name *
1st Parent/Guardian's Phone Number *
Parent/Guardian's Address *
2nd Parent/Guardian's (Legal) First Name *
2nd Parent/Guardian's (Legal) Last Name *
2nd Parent/Guardian's Phone Number
2nd Parent/Guardian's Address (if different)
Student's Birth Date *
MM
/
DD
/
YYYY
Grade Level in 2022-2023 *
Your Student's Neighborhood Chico Unified District School. (Where your child would go to school depending on your address) *
Student Gender at Birth *
Required
Sibling Information. Please include the names, grades, and ages of younger and school aged siblings. *If you wish to enroll more than one child, please fill a new form out for each student. *
Does your child have a special education individualized education plan (IEP) on file?
Does your child have a section 504 on file?
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