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4315 Lincoln Avenue
Oakland, California 94602
phone (510) 531-1300
fax (510) 531-2649
webmaster@headroyce.org

request information

For Kindergarten admittance in the 2011-12 school year, please note: Kindergarten Applicants must be 5 years old by September 1, 2011. Kindergarten tours are reserved for families with applicants meeting the age requirements.

01)	Applicant's First Name*

02)	Applicant Last Name*

03)

Are you applying for an additional child?*

	Yes
	No

04)	Second Applicant First Name

05)	Second Applicant Last Name

06)	Date of Birth (mm/dd/yyyy) - First Applicant*

07)	Date of Birth (mm/dd/yyyy) - Second Applicant

08)	Male/Female*

09)	Male/Female Second Applicant

10)	Grade entering in 2011-12 - First Applicant*

11)	Grade entering in 2011-12 - Second Applicant

12)	Address Line 1*

13)	Address Line 2

14)	City*

15)	State*

16)	Zip Code*

17)	Contact Phone Number*

18)	Parent/Guardian*

19)	Parent/Guardian Email

20)

Please select from the following:*

	Call me to schedule a Kindergarten tour*
	Mail me an application packet (grades 1-11 only)
	I will download application materials from the website (grades 1-11 only)

*Grades 1-5 should attend the Lower School Open House on Sunday November 21, 2010

Please Note: Questions marked with an asterisk (*) are required.