Wild Roots Pre-Admission Form (RSM Campus) - Wild Roots Holistic Learning Center

Wild Roots RSM Pre-Admission Intent Form

This Pre-Admission Intent Form confirms your interest in moving forward with enrollment at Wild Roots Holistic Learning Center. Once submitted, you will be provided with access to the full admissions packet for completion.

Enrollment Information

We are ready to enroll at Wild Roots RSM, having completed our decision-making process.(Required)

Confirming.

Number of Children to be Enrolled(Required)

Child's Name(Required)

First Last Age

Child 2's Name(Required)

First Last Age

Child 3's Name(Required)

First Last Age

Child 4's Name(Required)

First Last Age

Child 5's Name(Required)

First Last Age

Desired Start Date(Required)

Parent/Guardian Information

Parent/Guardian Name(Required)

First Last

Parent/Guardian 1 Email Address(Required)

Parent/Guardian 1 Phone(Required)

Is there a secondary parent/guardian?

Yes

Parent/Guardian 2 Name(Required)

First Last

Parent/Guardian 2 Email Address(Required)

Parent/Guardian 2 Phone(Required)

After submitting this form, you will receive an email at the address you provided. This email will include instructions on how to complete your full admissions packet. Please review everything carefully, and don't hesitate to reach out if any questions arise. We’re here to help!