2017-18 Enrollment information form- completed after lottery
Our lottery for the 2017-18 school year has passed. We still have limited openings in select grades. Please complete this form and we will let you know if we have a spot available for your child, or if they will be added to our waitlist. Thank you.
Student first name
Your answer
Student last name
Your answer
Student's grade for the 2017-18 school year
Student primary mailing address line 1
Your answer
Address line 2
Your answer
City
Your answer
State
Zip code
Your answer
Student's Date of Birth
MM
/
DD
/
YYYY
School district of residence
Current school name
Homeschooled students please enter 'Homeschooled'.
Your answer
Does student have a sibling who currently attends HCA?
Is student the child of an HCA founder or full-time faculty member?
Parent/ Guardian #1 Information
Parent/Guardian #1 first name
Your answer
Parent/Guardian #1 last name
Your answer
Parent/Guardian #1 relationship to student
Parent/Guardian #1 email address
Your answer
Parent/Guardian #1 primary phone number
Your answer
Parent/Guardian #1 address
(if different than student)
Your answer
What is the best way to reach parent #1?
Parent/Guardian #2 Information
Parent/Guardian #2 first name
Your answer
Parent/Guardian #2 last name
Your answer
Parent/Guardian #2 relationship to student
Parent/Guardian #2 email address
Your answer
Parent/Guardian #2 primary phone number
Your answer
Parent/Guardian #2 address
(if different than student)
Your answer
Parent/Guardian #2 city
(if different than student)
Your answer
Parent/Guardian #2 state
(if different than student)
Your answer
Parent/Guardian #2 zip code
(if different than student)
Your answer
What is the best way to reach parent #2?
Additional Information
How did you hear about HCA?
Next Steps
At this time we have limited openings in a few grades. If we have already filled the grade level you are inquiring about, you will be put on our wait list, which is first come, first served. If we have a space for your child, you will hear from us soon with details about your inquiry.

Thank you.

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