The Little School of Hillsborough

200 Davis Road,
Hillsborough, NC 27278

Application for Enrollment
To be completed and placed in child’s file prior to enrollment

* Application Date

* Projected Date of Enrollment

* Which school location are you applying for?

* Child's Name

Preferred Name

* Date of Birth

* Current Age

* Gender

Parent Information

* Parent's Name

* Last Name

* Home Phone

* Relationship to child

* Street Address

Address Line 2

* City

* State

* Zip Code

* Occupation/ Employer

* Day Phone

* Cell Phone/Pager

* Email Address

* Parent's Name

* Last Name

* Home Phone

* Relationship to child

* Street Address

Address Line 2

* City

* State

* Zip Code

* Occupation/ Employer

* Day Phone

* Cell Phone/ pager

* Email Address

Child Information

Siblings

Name

Age

Name

Age

Name

Age

Previous Group/School Experiences:

Each child in our school brings qualities that contribute to the strength of our
community. Please describe your child’s unique qualities.

What do your consider your child’s challenges?

What other information would be important for us to know in order to best meet your
child’s needs? (favorites, eating and sleeping habits, special fears, talents and
interests for example)

*

Are you interested in full time or part-time?

Full Time

Part Time Mon/Tues/Wed

Part Time Thu/Fri

*

Generally, what hours do you anticipate your child will be in attendance on a daily basis?

To complete your application we must receive a non-refundable application fee of $35.00
You can pay the deposit now with PayPal using a credit card.

Deposit for one child $35.00

Deposit for two children $70.00

Thank you for your application.

* Indicates Response Required