Online Application

Use the form below to apply to Weizmann school.

Student Information

Full Name

Address

City

State

Zip

Gender

• Male
• Female

Birth Date

Enrolling Grade

• Kindergarden
• First
• Second
• Third
• Fourth
• Fifth
• Sixth
• Seventh
• Eighth

School Currently Attending

School Previously Attended

What Languages are Spoken in Your Home?

Parent Information

Please check all that apply:

• Parents Married
• Parents Divorced
• Parents Separated
• Father Remarried
• Mother Remarried
• Father Deceased
• Mother Deceased
• Parent Other

With whom does the student reside?

Father or Legal Guardian

Full Name

Address (if different than above)

Phone (Home)

Phone (Work)

Phone (Cell)

Phone (Pager)

Email

Occupation

Business Address

Educational Background

Mother or Legal Guardian

Full Name

Address (if different than above)

Phone (Home)

Phone (Work)

Phone (Cell)

Phone (Pager)

Email

Occupation

Business Address

Educational Background

Additional

How did you hear about Weizmann Day School?

Please list your child's interests and extracurricular activities.

What are your child's academic strengths?

Has your child ever skipped or repeated a grade? If so, which grade?

Has your child any physical, medical, or other conditions of which we should be aware?

We welcome any additional comments you might like to make.