We would like to apply for admission to Open Fields School for the 2017-2018 school year

Name of child __________________________________________________
Address __________________________________________________
Telephone __________________________________________________
E-mail __________________________________________________
Date of birth __________________________________________________
School grade (or equivalent) completed __________________________________________________
Parents' names __________________________________________________
__________________________________________________
__________________________________________________ Signature of parent
__________________________________________________ Date

Please print and complete this application, and then mail it to:

Open Fields School
Nellie Pennington, Director
PO Box 53
Thetford, Vermont 05074