The Gardner School of Chicago – Lincoln Park 2850 N. Lincoln Ave. Chicago, IL 60657 Application for Wait List Date of Application: _____________________________________ Requested 1 st Date of Attendance: _________________________ I hereby apply for enrollment of my child to The Gardner School. CHILD INFORMATION Child’s Name ______________________________Nickname:____________________ Address: ____________________________________________________________ ___ Birth Date:_____________________________ Sex: Male Female Age: _____ PARENT / GUARDIAN INFORMATION Mother’s Full Name ______________________________________ Address: ____________________________________________________________ ___ Home Phone: ________________________Work Phone: _______________________ Email Address: ______________________________________ Father’s Full Name _______________________________________