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. Pay Fee Date Child's Name Birthday Sex MaleFemale Address Phone Allergies/Handicaps Parent One Name Phone Email Home Address Marital Status MarriedDivorcedSingleOther Place of Employment Work Address Work Phone Occupation & Hours of Employment Parent Two Name Phone Email Home Address Marital Status MarriedDivorcedSingleOther 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Work Phone Occupation & Hours of Employment Previous School Name of School/Care Center City State Start Date Date Withdrawn Reason for Leaving Additional Previous School Name of School/Care Center City State Start Date Date Withdrawn Reason for Leaving EMERGENCY For emergency medical treatment, my child should be transported to: Physician's Name or Clinic Address Phone Preferred Hospital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.