Parent/Guardian Name:
Telephone Number:
Address:
City:
State:
ZIP:
Student's name:
Student's date of birth:
Student's gender:
Student's current grade:
Has the student attended HHS's DLP program before:
The student will be enrolling:
If the student is enrolling part-time which
class or classes will the student be taking?:
Select one or multiple classes:
Language Arts
Math
Science
History
Bible
Other
Who will supervise the student's
work/progress?:
Supervisor's e-mail address:
Supervisor's relationship to student:
How will you be paying the tuition?:
How did you hear about us?:
|
