EmailMe Form - Pre-K/K Application for Admissions

Child's Full Name *

First Middle Last

Date of Birth *

MM / DD / YYYY

Gender

Male

Female

Application for Grade *

Place of Birth *

Citizenship

Parent / Guardian Name #1 *

Prefix First Last

Relationship *

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code

Phone Number *

### - ### - ####

Parent/Guardian #1
Preferred Email *

Employer *

Employer Phone *

### - ### - ####

Parent / Guardian Name #2

Prefix First Last

Relationship #2

Address #2 (if different)

Street Address Address Line 2 City State / Province / Region Postal / Zip Code

Phone Number #2

### - ### - ####

Parent/Guardian #2
Preferred Email

Employer #2

Employer Phone #2

### - ### - ####

Other Members of Household *

Tell us about your child in a few short sentences (please be certain to speak about your child’s emerging communication style and interactions with peers). *

Tell us about your family in a few short sentences. *

Has your child ever had any psychological/educational or neurological testing? If so, please describe. *

Describe your child’s social and emotional strengths and opportunities for growth. *

What is a goal or an area of improvement that you have for your child? *

What are your hopes and dreams for your child's early childhood education? *

What family activities does your child enjoy? What special hobbies does your child participate in outside of school? *

Do you have any concerns with your child’s age appropriate developmental milestone attainment? *

Is English the primary language spoken at home? Are there any other languages utilized at home? *

Is your child currently enrolled in a school or daycare? If so, for how long. Please describe your child’s educational background and experience. *

For PreK Applicants: Can your child use the toilet independently with minimal supervision, including wiping properly? (This is a requirement for enrollment in our program) *

Yes

No

Not Applicable (Kindergarten Applicant)

Can we request a letter from a previous teacher/childcare provider if applicable in regards to the child’s experience? *

Yes

No

Not Applicable

What holidays and traditions do you celebrate in your home? Are there any holidays or traditions you do not want your child to participate in in the classroom? *

Please describe any medical needs as they relate to your child. Any allergies? *

As part of this application to Academy Hill School, the applicant and his or her guardians agree to the following: The Academy Hill School Admission Office will consider this application and all other relevant information, as outlined in the Admission Procedures, if and when such material is complete. The undersigned grants Academy Hill permission to request and receive confidential information regarding the applicant and to retain such material in the applicant's file.

By selecting the "I/We Accept" button, you are signing this Application electronically. You agree your electronic signature is the legal equivalent of your manual signature on this Application. *

Please submit the $75 nonrefundable Application Fee with the Application by scanning the QR below. You may also pay the fee by going to https://www.academyhill.org/support or via mail to:
Academy Hill School
Admission Office
1190 Liberty Street
Springfield, MA 01104

Application Fee QR Code

Academy Hill School admits students of any race, color, sexual orientation, and national or ethnic origin. Academy Hill School does not discriminate in the selection of its governing board, in the employment of personnel, in the admission of students, in the administration of the school's programming, or the use of the school's facilities because of race, color, national origin, sex, veteran status, gender identification, age, sexual orientation, or qualified handicapped students in violation existing state or federal law or regulations.

Questions?