For each child interviewing:
Name:                                           Date of Birth:

Name:                                           Date of Birth:

Name:                                           Date of Birth:

Please tell us the names of adults accompanying the interviewee:
(As a matter of policy we require both parents or guardians to attend the interview)

Email address:

Mailing address:

Daytime Phone:                                                   Evening Phone:

Whose number is it?                                           Whose number is it?

How did you hear about Sudbury Valley?

This form should be accompanied by a $30 non-refundable fee per child.
If paying by check or money order, rather than by credit card, send your check or money order to: The Sudbury Valley School, 2 Winch Street, Framingham, MA 01701

Credit Card information

Name on Card:

Billing address (if different than mailing address)

Bill my Choose a card Master Card Visa American Express Discover credit card.

Credit Card number:                                               Expiration Date: (month/year)
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