Haleakala Waldorf School

We would love to mail you a packet of information, please help us by providing the following:

Name:

Address:

Phone:

Fax:

Email:

Child Information

Name of Child (1):

Name of Child (2):

Name of Child (3):

Referral source

(please check all that apply & fill blanks accordingly)

Word of Mouth:
Ad in magazine / news / phonebook
Event:
World Wide Web
Attends other Waldorf School
Other:

Notes: