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Admissions Interview Form

Name(s) and age(s) of the prospective student(s)_______________________________________
____________________________________________________________________________

Name(s) and address(es) of adults accompanying interviewee: (As a matter of policy, we require
both parents or guardians who live in the immediate area, to attend the interview.)

Name:_______________________________________________________________________

Address:_____________________________________________________________________
____________________________________________________________________________

City:______________________________ State:_____________________________________

Zip Code:_________________________ Telephone:__________________________________

Telephone during daytime:_______________________________________________________

Email address:_______________________________________________________

Name:_______________________________________________________________________

Address:_____________________________________________________________________
____________________________________________________________________________

City:______________________________ State:______________________________________

Zip Code:_________________________ Telephone:___________________________________

Telephone during daytime:________________________________________________________

Email address:_______________________________________________________

How did you hear about Diablo Valley School?________________________________________

Please complete this form and submit during your interview with a non-refundable $15.00 fee to Diablo Valley School.

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[for office use only]

Date and time of interview:_______________________________________________________

Fee Paid: ( ) Date:_____________________ Interviewed by:____________________________

Comments:__________________________________________________________________