Student Mundane Name _________________________________________     Parent(s) Name ______________________________________________

Student SCA Name (optional) _____________________________________    Parent SCA Name ____________________________________________

Street Address _______________________________________     City, State Zip _______________________________________________

Phone Number ___________________    Local SCA Group ___________________________________________________

Birthdate________________     Date of enrollment ___________________________

Has this student been involved in other Page Schools or Guilds? ___________

If so, please specify (both type and location) _______________________________________________________________________________________

Level attained in previous Page School/Guild ___________________________

Tell us about the Page (interests, previous or current projects, experiences):
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Please list any questions/suggestions/comments/concerns below:
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Date received by Page School Staff: ___________________

Date confirmation of enrollment sent: __________________