OLHCA 2018-2019 Intention to Enroll
Please provide the following information if you intend to enroll your child(ren) for the 2018-2019 Academic Year. Be sure to include any children who may be entering Kindergarten.
Parent/Guardian Information
Email Address *
Your answer
Name *
Your answer
Contact Number *
Your answer
Street Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Student Information
Enter the following information for any children you wish to enroll in the Academy.
1st Child's Name, Date of Birth, Grade *
Your answer
2nd Child's Name, Date of Birth, Grade
Your answer
3rd Child's Name, Date of Birth, Grade
Your answer
4th Child's Name, Date of Birth, Grade
Your answer
5th Child's Name, Date of Birth, Grade
Your answer
6th Child's Name, Date of Birth, Grade
Your answer
Questions/Comments?
You may also use this space to provide information for additional children.
Your answer
Signature *
Please print your name (First, Middle Initial, Last) to verify your registration. You will be given the opportunity to review and edit your responses, if necessary.
Your answer
Date *
MM
/
DD
/
YYYY
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.