Child's Name *
Child's Name
Child's Date of Birth *
Child's Date of Birth
(Children must be 2.9 by the start of the school year.)
Name of Parent 1 *
Name of Parent 1
Mailing Address *
Mailing Address
Phone *
Phone
Name of Parent 2
Name of Parent 2
Mailing Address
Mailing Address
Phone
Phone
Of which town are you a resident? *
(Priority is given to residents of the Up-Island Regional School District. Enrollment is first offered to families residing in Chilmark or Aquinnah, then West Tisbury and then the down island towns.)
(Priority is given to families currently enrolled in the Chilmark School.)
(Priority is given to families intending to enroll in the Chilmark School.)
Preferred Schedule *
(Please select one. School day is 8:00-3:00 pm. Priority is given to families choosing the 5 day option.)