Desired School Year

Fall 2024

Spring 2025

Student Name *

First Name

Last Name

Home Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Home Phone

(###)

###

####

Phone Number

(###)

###

####

Name

First Name

Last Name

Phone

(###)

###

####

Applicants for Toddler Program (ages 18-36 months)

Please check off which half days your child will be attending. Please note that all children will need to register for a minimum of 3 half days. You may choose morning and afternoon.

5 Full

4 Full

3 Full

5 Half

4 Half

3 Half

Days of the Week

Please choose your desired days of the week you would like your child to attend.

Monday

Tuesday

Wednesday

Thursday

Friday

To Whom Correspondence should be sent*

Both Parents

Parent I

Parent II

Select if Applicable

Parents Divorced

Parents Married

Single Parent

Mother Remarried

Father Remarried

Mother Deceased

Father Deceased

Parents Separated

We certify that no information concerning this applicant has been withheld or misrepresented.*

First Name

Last Name

My Child has permission to be photographed by Hudson Hills Staff or the media throughout the 2024-2025 calendar year as a part of any promotional story about Hudson Hills. *

Yes

No

Your application is regarded as a formal request for consideration of your son or daughter as a potential student at Hudson Hills Academy, and as authorization to obtain transcripts and recommendations from previous schools. Hudson Hills Academy welcomes and considers all applications without regard to race, religion, or ethnic, or national background. Hudson Hills Academy admits students of any race, religion, or ethnic origin to all the rights, privileges, programs and activities generally accorded or made available to students at Hudson Hills. Hudson Hills Academy does not discriminate in any way to the basis of race, color, nationality, or ethnic origin or in the administration of its educational policies.* *

ACCEPT ABOVE TERMS

Electronic Signature of Preparer/Parent *

First Name

Last Name