APPLICATION PROCEDURE

1. Submit application and non-refundable fee of $75.00 to
Evergreen School. Checks should be made out to Evergreen School
and mailed to 10700 Georgia Avenue, Wheaton, MD, 20902.
MasterCard or Visa payments should be made over the telephone to
Michele Gadson or Lorie Allion at 301-942-5979. Online payment
is not available at this time.

2. All prospective students as well as parents must be
interviewed by the Head of School. In addition, students
age 4 and older may be required to visit the school for up
to 3 days.

3. All deposits, fees, & forms are required upon acceptance to
Evergreen School.

Evergreen School has a policy of non-discrimination regarding
race, religion, and ethnic origin for admission of students and
the employment of faculty and staff.

Evergreen School considers the records of all individual
students to be confidential information, available to a child's
parents or guardians upon request. Records will be released to
other schools or agencies only upon signed request from a
parent or guardian and only after all accounts due are paid in
full.

*Required fields

First Name*

Middle Name

Last Name*

Sex* Male     Female

Independent toileting established?*
Yes No

Nickname

Birthdate*

Age*

Place of Birth

Reasons for applying to Evergreen*

Previous School Experience*

School

Duration*

Type of Program*

Parent/Guardian 1

Full Name*

Street Address*

City*

State*

Zip Code*

Cell Phone*

Email*

Occupation, Title*

Employer

Business Phone*

Parent/Guardian 2

Full Name*

Street Address

City

State

Zip Code

Cell Phone

Email

Occupation, Title

Employer

Business Phone

Person Responsible for Bills*

Parents live together*
Yes No

Parents live separately*
Yes No

Parents are divorced*
Yes No

Other parent or guardian, if applicable.

Home Address

Home Phone

Occupation, Title

Employer

Business Phone

Business Fax

Health

Allergies*

Restrictions*

Physical Limitations or Special Needs*

Siblings*

Names and Ages

Signature

*Previous school and diagnostic records must be provided to Evergreen School
as a condition of enrollment for all students entering from another institution.