New Student Application

Thank you for your interest in James River Day School. Please complete an online application for each child seeking admission. The application(s) may be submitted online below.

Please Note: There is a non-refundable one time application fee of $50 per applicant. After completing the application, you will be given the opportunity to pay the application fee online.

Required fields are marked *.

Applicant Information

Applicant's first name:*

Answer Required

Applicant's last name:*

Answer Required

By what name, does this child prefer to be called?

Answer Required

What is this child's gender? (optional question)

Answer Required

female

male

What is this applicant's birthdate?*

(mm/dd/yyyy)

Answer Required

Please enter the applicant's address.*

Answer Required

City, state, and zip code*

Answer Required

Applicant's Current School

Please enter the name of the applicant's current school.

Answer Required

What years did the applicant attend the above named school?

Answer Required

What is the address of the school entered above?

Answer Required

City, state, and zip code

Answer Required

What is the name of the school's director or principal?

Answer Required

The school's phone number is?

(xxx-xxx-xxxx)

Answer Required

Family Information

Parent/Guardian #1

First name*

Answer Required

Middle initial

Answer Required

Last name*

Answer Required

By what name does this parent/guardian prefer to be called?*

Answer Required

Suffix

Answer Required

Sr.

Jr.

III

Other:

This parent/guardian's address is? Please include the full address (street address, apartment number if applicable, city, state, and zip code.)*

If this address is the same as the applicant's address listed above, simply put "same" in the field below.

Answer Required

What is this parent/guardian's preferred email address?*

Answer Required

What is this parent/guardian's preferred phone number?*

(xxx) xxx-xxxx Also include an extension number if this is a work phone.

Answer Required

Parent/Guardian #2

If there is no second parent/guardian in your family, select "This applicant only has one parent/legal guardian" where applicable and enter "none" in any other required fields.

If the second parent/guardian shares the same address or other contact information as parent/guardian #1, simply mark those fields with "same."

First Name*

Answer Required

Middle Name

Answer Required

Last Name*

Answer Required

By what name does this parent/guardian prefer to be called?*

Answer Required

Suffix

Answer Required

Jr.

Sr.

III

Other:

Does this parent/guardian have legal custody of the applicant?*

Answer Required

yes

This applicant has only one parent/guardian.

This parent's/legal guardian's mailing address is? Please include the full address (street address, apartment number if applicable, city, state, and zip code.)*

If this address is the same as the applicant's address, enter "same" here.

Answer Required

What is this parent/guardian's preferred email address?*

Answer Required

What is this parent/guardian's preferred phone number?*

(xxx) xxx-xxxx Please include the extension number if this is a work phone.

Answer Required

Does the applicant have any siblings? If yes, enter the oldest sibling's full name below. If the applicant is an only child, please enter "none."*

Answer Required

What is this sibling's date of birth?

Answer Required

What is this sibling's current school?

Answer Required

If there are additional siblings, please enter their information here. List each sibling's full name, date of birth, and current school.

Answer Required

Please list the names of any relatives who have attended JRDS and their relationship to the applicant.

Answer Required

Is the applicant able to meet the essential performance requirements of the program, either with or without reasonable accommodations?*

Answer Required

Yes

Is there any additional information you wish the Admissions Committee to consider when reviewing this application?

Answer Required

I (we) attest that all of the information provide in this application is true and correct to the best of our knowledge. Further, I (we) understand and accept that falsification or deception in any aspect of the application process may result in an immediate review and possible revocation of admission.*

Answer Required

Yes

Acknowledge the above by entering the full name of the person completing this form in the field below.*

Answer Required

If you have any questions about the application process, please contact Sally Horner, Associate Head of School for Enrollment, at 434-455-4763.

Thank you for considering James River Day School for your child. We look forward to getting to know your family during the admission process.

Please fix the highlighted areas below before submitting.

Applicant Information

Applicant's Current School

Family Information

Parent/Guardian #1