*Student's First Name:
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Student's Nickname:
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Student's Middle Name:
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*Student's Last Name:
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| Student's Suffix (Jr., III, Etc.): | |
| *Student's Gender: | | |
*Student's Date of Birth (mm/dd/yyyy):
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*Student's Current School:
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| *How did you hear about Rivers? | |
| If other, please list: | |
| *Current Grade: | |
| *Entry Grade: |
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| *Desired Year of Entry: | |
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*Student's Home Address (Street):
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*Student's Home Address (City):
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| *Student's Home Address (State): | |
| *Student's Home Address (ZIP/Postcode): | |
*Student's Home Phone:
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| *First Parent's Relation to Student: | |
| *First Parent's Prefix (Mr., Ms., Mrs., Dr., Etc.): | |
*First Parent's First Name:
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First Parent's Middle Name:
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*First Parent's Last Name:
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| First Parent's Suffix (Jr., III, Etc.): | |
*First Parent's Phone:
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First Parent's Cell Phone:
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*First Parent's Email:
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First Parent's address if different than student address:
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| Second Parent's Relation to Student: | |
| Second Parent's Prefix (Mr., Ms., Mrs., Dr., Etc.): | |
Second Parent's First Name:
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Second Parent's Middle Name:
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Second Parent's Last Name:
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| Second Parent's Suffix (Jr., III, Etc.): | |
Second Parent's Phone:
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Second Parent's Cell Phone:
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Second Parent's Email:
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Second Parent's address if different than student address:
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| Will your family be applying for Financial Aid? | | |
| If yes, please call the Admissions Office for Financial Aid forms and The Rivers School policies and procedures. |
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| Student has sibling(s) in the school: | | |
Name of sibling(s) at Rivers (if yes):
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Please list any family members who have attended Rivers:
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| *Specific Areas of Interest: (Ctrl-Click on mouse for multiple selections, Cmd-Click on a Mac) Select as many as desired. | |
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Other Areas of Interest:
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