Clone of 2025-2026 Application for Enrollment in CECDS

Application for Enrollment

in Christ Episcopal Church Day School
Child's Name

First NameMiddle NameLast Name
Child's Preferred Name
Birth Date

MonthDayYear
Gender
Address

Street Address

Street Address Line 2

CityState

Zip Code
Class Applying For (Note: All classes are offered 3 days a week)
Child's Previous School Experience, If Any
Father's Name

First NameLast Name
Father's Address
Father's Address

Street Address

Street Address Line 2

CityState

Zip Code
Father's Cell or Home Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Father's Email
example@example.com
Father's Occupation
Father's Employer
Father's Business Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Mother's Name

First NameLast Name
Mother's Address
Mother's Address

Street Address

Street Address Line 2

CityState

Zip Code
Mother's Cell or Home Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Mother's Email
example@example.com
Mother's Occupation
Mother's Employer
Mother's Business Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
We offer Priority Registration if: (Check all that apply)
Siblings
HEALTH INFORMATION

The State Board and the Maryland State Medical Society, the Department of Health and Mental Hygiene require that children be up-to-date on their immunizations to attend school or childcare. To find out current immunization requirements, or if you have any questions about immunizations, please contact your child's doctor. Please be aware that children will not be allowed to attend school until we have received a complete and up-to-date immunization record signed by your child’s physician.
Is there a history of Diabetes, Rheumatic Fever, Epilepsy, Allergy, or any physical impairment (glasses, hearing aid, etc.) that may necessitate your child being given special attention?
Does your child have any special needs?
Does your child have an IEP?
Additional Comments Regarding Child's Health
Why did you choose Christ Episcopal Church Day School for your child?
How did you learn about CECDS?
I have read and understand the above Tuition Statement and Agreement, a copy of which will be provided with the completed application.
Sender's Email (Required - to receive confirmation)
example@example.com
To complete this application, please sign by typing your name below, submit the $150 non-refundable application fee, (either online by responding Yes to the next question or by mailing a check to CECDS, PO Box 141, Stevensville, MD 21666) and click Submit Application. Your child's application is not complete until we receive BOTH the completed form and the application fee.
Would you like to pay the application fee now by credit card?

Christ Episcopal Church Day School admits students of any race, religion, or national or ethnic origin and does not discriminate in the administration of its educational policies, admission policies, or other school-administered programs.
Should be Empty:

Application for Enrollment

HEALTH INFORMATION

Credit Card Payment of Application Fee

Credit Card