ENROLLMENT APPLICATION 
 
 
 
A $75.00 NON-REFUNDABLE ONLINE REGISTRATION FEE PER CHILD MUST ACCOMPANY THIS FORM. THIS FORM IN NO WAY GUARANTEES YOU A SPACE FOR YOUR CHILD FOR A SPECIFIC TIME OR PLACE. IT WILL PLACE YOU ON THE WAITING LIST FROM WHICH WE FILL VACANCIES.
 
Sponsor Parent/Guardian (Parent affiliated with Emory, CDC, CHOA) Information
* First Name 
* Last Name 
* Relationship 
* Email 
* Address 
* City 
* State 
* Zip 
* Cell Phone 
  Home Phone 


Sponsor Parent Work Information
* Employer 
* Occupation 
* Address 
* City 
* Phone 


Parent/Guardian #2 Information
  First Name   Last Name 
  Relationship    Email 
  Address   City 
  State   Zip 
  Cell Phone 
  Home Phone 


Parent/Guardian #2 Work Information
  Employer   Occupation 
  Address   City 
  Phone 


Additional Information
  
Is Sponsor Parent... 
* an Emory student? 
* a contractor with the CDC? 
     
Only CDC Contractors with children between the ages of 3-5 yrs old may enroll.  


Tuition Assistance
* Requested 
     
Income-based tuition assistance is available to benefit-eligible employees of Emory, CDC, and CHOA. Please refer to your confirmation email for more details about the subsidy scale with income requirements for each employer. This tuition assistance is not available to students.  


Terms of Agreement
     
IN THE EVENT THAT YOU ARE CALLED TO FILL A SPACE AND THE OFFER IS DECLINED, YOU MAY REQUEST TO RETURN TO THE BOTTOM OF THE WAITING LIST UNTIL A SECOND OFFER IS MADE. IF THE SECOND OFFER IS DECLINED, YOUR NAME WILL BE TAKEN OFF THE WAITING LIST. IF YOU WANT TO REMAIN ON THE WAITING LIST AFTER YOUR SECOND OFFER, YOU WILL BE REQUIRED TO PAY AN ADDITIONAL REGISTRATION FEE OF $75.00.  
* Indicate 


* Parent Name 
* Date 


Registered Child(ren)

To register your child(ren), please click Add Child.



Privacy Policy
We keep your personal information private and secure.

Contact Us
The Clifton School @ Clifton •• 1700 Clifton Road NE, Atlanta, GA 30329 •• 404-636-4073 •• abourne@thecliftonschool.org
The Clifton School @ Clairmont •• 1900 Starvine Way, Atlanta, GA 30322 •• 404-315-6340 •• dgunn@thecliftonschool.org

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