*
Required
School Division
*
required
Please Select…
Lower School (Grades PreK3 to 5)
Middle and Upper School (Grades 6 to 12)
Select an Open House Date
*
required
Please Select…
Tuesday, January 24, 2017
Registration begins at 8:15 A.M. in H2 in Lower School.
Select an Open House Date
*
required
Please Select…
Thursday, January 26, 2017
Registration begins at 8:15 AM in the Needham Conference Center (NCC).
How many people will attend the open house?
*
required
Please Select…
1
2
3
4
5
How many people will attend the open house?
*
required
Please Select…
1
2
3
4
5
Title*
Mr.
Dr.
Name of Father
*
required
Title*
Mr.
Dr.
Name of Father
*
required
Title*
Mrs.
Ms.
Dr.
Name of Mother
*
required
Title*
Mrs.
Ms.
Dr.
Name of Mother
*
required
Are parents separated/divorced?*
Yes
No
Are parents separated/divorced?*
Yes
No
Home Address Street
*
required
Address 2
City
*
required
State
*
required
Zip Code
*
required
Home Address Street
*
required
Address 2
City
*
required
State
*
required
Zip Code
*
required
Preferred Contact Method
*
required
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Daytime Phone Number
Evening Phone Number
Email
Preferred Contact Method
*
required
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Daytime Phone Number
Evening Phone Number
Email
Daytime Phone
*
required
Daytime Phone Number is
Home
Work
Mobile
Evening Phone Number
Evening Phone Number is
Home
Mobile
Email Field
*
required
Email Address is
Father's
Mother's
Potential Enrollment Year
2016-2017
2017-2018
Potential Enrollment Year
2016-2017
2017-2018
Number of children who may attend CSN
*
required
Please Select…
1
2
More than 2
Name of child 1
*
required
Gender of child 1
*
required
Please Select…
Female
Male
Grade entering for child 1
*
required
Please Select…
PreK3
PreK4
Kindergarten
1st grade
2nd grade
3rd grade
4th grade
5th grade
Current School Child 1
*
required
Name of child 2
*
required
Gender of child 2
*
required
Please Select…
Female
Male
Grade entering for child 2
*
required
Please Select…
PreK3
PreK4
Kindergarten
1st grade
2nd grade
3rd grade
4th grade
5th grade
Current School Child 2
*
required
More than 2 children?
If you have more than 2 children who may attend CSN, please enter their Name, Current Grade, Grade Entering, and Potential Year of Enrollment in the box below.
Number of children who may attend CSN
*
required
Please Select…
1
2
More than 2
Name of child 1
*
required
Gender of child 1
*
required
Please Select…
Female
Male
Grade entering for child 1
*
required
Please Select…
6th grade
7th grade
8th grade
9th grade
10th grade
11th grade
12th grade
Current School Child 1
*
required
Name of child 2
*
required
Gender of child 2
*
required
Please Select…
Female
Male
Grade entering for child 2
*
required
Please Select…
6th grade
7th grade
8th grade
9th grade
10th grade
11th grade
12th grade
Current School Child 2
*
required
More than 2 children?
If you have more than 2 children who may attend CSN, please enter their Name, Current Grade, Grade Entering, and Potential Year of Enrollment in the box below.
Please send a confirmation email to the address below:
Please provide an email address where we can send a link to your current form.
Email Address :