Apply - Union Hill Day School

Application for Union Hill Day School

Note: We do encourage you to schedule a tour before applying to our school.

step one

Open the application form to fill out in your browser.

step two

Save the form to your computer and email it as an attachment to unionhillday@gmail.com.

step three

Pay the $120 registration fee.

Date

Child's Name

Birthday

Sex

Address

Phone

Allergies/Handicaps

Parent One

Name

Phone

Home Address

Marital Status

Place of Employment

Work Address

Work Phone

Occupation & Hours of Employment

Parent Two

Name

Phone

Home Address

Marital Status

Place of Employment

Work Address

Work Phone

Occupation & Hours of Employment

Previous School

Name of School/Care Center

City

State

Start Date

Date Withdrawn

Reason for Leaving

Additional Previous School

Name of School/Care Center

City

State

Start Date

Date Withdrawn

Reason for Leaving

EMERGENCY
For emergency medical treatment, my child should be transported to:

Physician's Name or Clinic

Address

Phone

Preferred Hospital

Address

Phone

Dates and Status:

Date Preferred

Date Promised

Start Date

Full TimePart TimeInfantToddlerPre-SchoolPre-KindergartenKindergartenSummer

If requesting Part Time, days requested:

Acknowledgement
I understand that I will need to sign a form in office before beginning and that I am responsible for paying the $120 application fee on the following page after hitting the Submit button.