Application for admission

Please fill out all fields in the form below.

Please note that you will be contacted by the admissions staff once your application has been processed. This process may take several weeks.

Child's first and last name: *
Child's Nickname (if any):
Child's date of birth (MM/DD/YYYY): *
Child's age by September 2024: * (Please indicate the exact number of years and months)
How did you hear about us?: *
Please select one of the following options
AM/PM: *	AM PM Saturday
Address (Please use the address where the child resides)
Street Address, Apt. #: *
City, State, Zip Code: *
Home Phone: *
Child's knowledge of Russian
Please describe the child's knowledge of Russian: *
Please list languages spoken at home: *
Parents' Information
Parent 1 first and last name: *
Parent 1 occupation and employer: *
Parent 1 cell phone: *
Parent 1 work phone: * (Please repeat cell phone number, if appropriate.)
Parent 1 email: *
Parent 2 first and last name: *
Parent 2 occupation and employer: *
Parent 2 cell phone: *
Parent 2 email: *
Parent 2 work phone: * (Please repeat cell phone number, if appropriate.)
Please tell us about your child and your family:
Please upload a recent photograph of your child: * (Make sure that the file is less than 20MB in size, otherwise you will not be able to submit the application.)
Please list other schools and programs your child attends: *
If you have previously submitted an application to this program, please indicate the academic year for which you have applied: * (If you have not previously submitted an application, please mark N/A)
Captcha: *
	Please fill this form correctly. Fields marked * are required.

Please contact us at admissions@pushkinacademy.com if you are having trouble submitting this application.

Saturday Location: