Online Application Student InformationStudent Name Name Child is Called Gender Female Male Date of Birth MM slash DD slash YYYY Parent/Guardian 1 Full Name Email Home Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Mobile PhoneWork PhoneHome PhoneOther PhoneSecond Parent/Guardian InformationParent/Guardian 2 Full Name Home Address (if different from above) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email Work PhoneMobile PhoneOther PhoneOther Household InformationOther members of householdNameRelationship to child Authorized Caregivers Names SNS Programs Yellowbird Child turns 2 by Sept 1. Bluebird Child turns 3 by Sept 1. Redbird Child turns 4 by Sept 1. Program Applying For*SelectYellowbird (2 year-olds)Bluebird (3 year-olds)Redbird (4 year-olds)Bluebird OptionsBluebird Days PreferenceSelect PreferenceBluebird Three DayBluebird Four DayBluebird Five DayCo-op OptionPreferred Co-op Option (see website for full description)FlexFlex + No EFixed 2+1EFixed 2+ no EFixed 1+ 1EFIxed 1+ no EGeneral QuestionsPlease note that any information provided in our application form is confidential and will not influence acceptance.Select One: New Student Returning Student Sibling of Current/Former Student Current/Former Student Name Sibling Sitting Yes, I am interested in participating No, thanks! SNS offers a sibling sitting program for younger children while you co-opPurplebirds (Afternoon Enrichment Program) Yes, I am interested in participating No, thanks! SNS offers afternoon enrichment from 12:15-300pm for Bluebirds (3's) and Redbirds (4's) that are no longer regularly napping and are potty trained.Early Morning Birds Yes, I am interested in participating No, thanks! If you answered yes, you would be interested in applying for Purplebirds and/or early morning hours, please indicate the estimated number of days (1-5) you would prefer. Note this is not a binding agreement and spaces will be offered only if available.What is the primary language spoken in your home?If other than English, does your child speak or understand English?Does your child have prior Nursery School/Play Group experiences? Yes No Name of school(s) and length of time attended:Did your child enjoy the experience?Why do you want your child to attend Suburban Nursery School?How did you hear about Suburban Nursery School?This application is not complete without submitting the co-op agreement and payment of $65 for the application fee ($40 for each additional sibling application) either by check or online with PayPal, credit, or debit by clicking on the Paypal link on the application page. Checks should be made payable to Suburban Nursery School and sent to: Suburban Nursery School Admissions, 7210 Hidden Creek Rd, Bethesda, MD 20817. NOTE: The application fee is waived for current students. SUBURBAN NURSERY SCHOOL CO - OPING AGREEMENT A cooperative nursery school gives parents the unique opportunity to be part of their child’s first school experience. As the name implies, in a cooperative everyone’s active participation is important to making it work. The children are happiest when they, their parents, and teachers work together openly and “cooperatively.” Suburban Nursery School has functioned in this manner for the last fifty - plus years, through the combined efforts of our teachers and the parents. Please find below an outline of your responsibilities as a co-oping parent. 1. Co - oping : Each parent is expected to “co - op” at Suburban. On a scheduled day, the child’s parent or guardian assists the teacher and performs all necessary tasks as indicated by the teacher. The parent must arrive on time; failure to do so unfairly shifts the burden of work to other parents. 2. Parent Meetings: At least one parent from each family is required to attend all parent meetings. There is an orientation meeting at the beginning of the year for all families, and one or two meetings throughout the year for each class. At year’s end, we have another meeting to elect the new Board. Teachers may, at their discretion, cancel or add more meetings if they determine there is a need. Your attendance and participation at these meetings is valuable and necessary; failure to attend the annual, school - wide meetings (in September and April) without an excused absence from the president could result in a fine. 3. Committee or Board Service: Each parent is required to work on one of the committees, which help run the school which can include, but is not limited to, Membership & Hospitality, Housekeeping and Maintenance, Fundraising and Communications, art, science, and enrichment or to serve on the Board. Parents are welcome to attend Board meetings, which are held monthly. 4. Open Communication: We stress the need for open, frank, and fair communication among parents, the Board, and the teachers. Should you have any questions, concerns, or suggestions, please share them with the teachers, with a Board member, or with your class representative. You will be listened to. Constructive suggestions are always appreciated. 5. Set Up/Pack Up Days: One parent is required to attend and participate in set-up and pack-up at the beginning and end of the school year respectively. Failure to attend these days without an excused absence from the President could result in a fine. 6. Background Check: Maryland State Department of Education's Office of Child Care (OCC) requires fingerprinting for any co-oping parent who may be left alone with any child/children other than their own. Each parent must have a Criminal Background Check (CBC) on file with the OCC. This background check is processed through the MD State and FBI databases. Co-oping parents must schedule and pay for their background check. 7. Immunization & Medical Records Policy: Suburban Nursery School requires that all students enrolled be fully immunized and does not accept any waivers or exemptions. Parent(s) must furnish evidence of age-appropriate immunity against Tetanus, Diptheria, Poliomyelitis, Measles (rubeola), Mumps, Rubella, Hepatitis , Varicella, Meningitis, and Tetanus-diphtheria-acellular pertussis (T-Dap). Minimum vaccine requirements and Maryland Department of Health COMAR 10.06.04.03 are available at health.maryland.gov. Additionally, both children and co-oping parent(s) must be tested for tuberculosis and provide medical reports annually. By typing my name below I agree I have read Suburban Nursery School’s Co-oping Agreement and understand what is required of me. I hereby agree to meet my co-oping responsibilities.By typing my name below I agree I have read Suburban Nursery School’s Co-oping Agreement and understand what is required of me. I hereby agree to meet my co-oping responsibilities. PhoneThis field is for validation purposes and should be left unchanged.