St. Peter's Episcopal School
3695 Rogers Avenue.

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Child's Name and Date of Birth

Gender (Please select one)

Male

Female

Parents' Names

Address

Emails and Phone Numbers (Please include all relevant contacts and specify Home/Work/Cell/Email)

Are you a pledging member of St. Peter's Episcopal Church? How did you learn about St. Peter's?

Are you interested in the Extended Day program?

Yes

Does your child have any allergies? If yes, please specify

Does your child have an Individualized Family Service Plan (IFSP) or Individualized Education Program (IEP)?

Yes

If yes, please provide a copy so that we may work together to support your child's development and learning)

By clicking "Register", you agree to the $150 registration fee and tuition payment schedule for St. Peter's Episcopal School