Wild Roots Application
Thank you for your interest in Wild Roots program in Santa Barbara / Goleta!  The first step is to complete the application.

Sept 2022-June 2023 Mixed Age Preschool program and Kindergarten program

Applicants will be contacted to confirm receipt of your application.

The non-refundable application fee ($25) is due to attend an info session, interview, or visit.  Please send $25 by PayPal to wildroots.sb@gmail.com, or mail a check made out to Wild Roots, 6249 Momouth Ave, Goleta, CA 93117.

Wild Roots does not discriminate on the basis of gender, race, religion, or national origin in its admission policy or conduct of its educational programs.

Contact with questions: registrar.wildroots@gmail.com
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Child's First Name *
Child's Last Name *
Child's Birthdate *
MM
/
DD
/
YYYY
Child's Gender *
Ethnicity (optional)
Program Interest *
Parent / Guardian First Name *
Parent / Guardian Last Name *
Your Email Address *
Repeat Your Email address, so we're sure to have it right *
Your Daytime Phone Number *
Full Address (street, city, state, zip) *
Occupation / Employer *
Two-parent families:  Please fill out the second parent/guardian information below.
2nd Parent / Guardian First Name
2nd Parent / Guardian Last Name
2nd Parent / Guardian Email
2nd Parent / Guardian Phone Number
Occupation / Employer
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