Nursery Application - dates of birth between October 2, 2020 and April 30, 2022 for the 2024/2025 School Year 
We are proud to be a participant in Boulder County's CCAP program in our preschool program. Please know that our CCAP spots are all filled for the 2023/2024 school year. We do expect to have a limited number of spots for the 2024/2025 school year.
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Email *
Schedule Preferences
Anticipated Date of Enrollment *
How many days would you like your child to attend? *
What is your first schedule preference for the morning program (8:30am - 12:30pm)? *
What is your second schedule preference for the morning program (8:30am - 12:30pm)? *
Please indicate the days you would like in our Afternoon Rest Program (12:30 - 4:00). *
Contact Information
Child's First Name *
Child's Middle Name *
Child's Last Name *
Child's Date of Birth *
Child's Gender *
1st Parent's Name *
1st Parent's Email Address *
1st Parent's Primary Phone Number *
1st Parent's Street Address *
1st Parent's City *
1st Parent's State *
1st Parent's Zip Code *
1st Parent's Employer
1st Parent's Work Address
1st Parent's Work Phone
2nd Parent's Name
2nd Parent's Email Address
2nd Parent's Primary Phone Number
2nd Parent's Street Address
2nd Parent's City
2nd Parent's State
2nd Parent's Zip
2nd Parent's Employer
2nd Parent's Work Address
2nd Parent's Work Phone Number
Siblings - Please list siblings name, date of birth, and gender
Family Questionnaire
Please describe the pregnancy and birth ( i.e. c-section, complications during pregnancy and birth, adoption, etc). *
Please give a description of your home situation and daily rhythm. *
What types of family activities do you enjoy together? *
Please describe your child's current or past day care or school experience, if any. *
Do you have any concerns about your child from past day care, school, or group experience?  Please describe. *
Please describe your child's strengths. *
Please describe any aspect of your child's personality you'd like to see strengthened. *
Please comment on your child's like and dislikes, special circumstances or experiences, fears, etc. *
Please describe how your child plays with other children. *
Please describe how your child plays alone. *
What types of food does your child like to eat? *
Screen Time and Media
How much time, on average, does your child spend on the following?
Listening to radio, records, tapes - per weekday? *
Listening to radio, records, tapes - per weekend? *
Watching TV, VCR/DVD, movies - per weekday? *
Watching TV, VCR/DVD, movies - per weekend? *
Playing computer games - per weekday? *
Playing computer games - per weekend? *
We ask that you consider your child’s viewing habits in light of the increasing evidence of its adverse effects on children and their development.  (A reading list is available upon request.)  Are you willing to change your child’s television viewing habits if your teacher feels it would benefit your child?  Please answer as fully as you are able. *
Develomental Milestones
Please let us know at what age your child accomplished the following milestones.
Crawl *
Sit Up *
Walk *
Grow first tooth *
Speak first word *
Speak in 4-5 word sentences *
Please describe your child's development regarding the following:
Putting on shoes *
Helping with coat *
Pulling on pants *
Tying a shoe *
Toilet training (In general, our expectation is that children over the age of three are toilet trained.  If your child is having developmental or medical issues that delay toilet training, please be sure to inform us.) *
Medical History
What illnesses has your child had, particularly including measles, mumps, diphtheria, rubella, shigella, hepatitis (type?), meningitis (type?), salmonella, chicken pox, or giardia? *
Does your child have any allergies or health issues? *
Why are you considering Waldorf education for your child? *
Have you attended an in-person BWK Parent Tour?     *
If you have attended a tour, what was the date?
Have you watched our virtual tour?     *
If you watched our virtual tour, what was the date?
How did you hear about this program?  If you found us on the web, which websites and search engines, and what words did you search on? *
Anything else you would like to add?  
A copy of your responses will be emailed to the address you provided.
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