Request for Enrollment or Information

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.

Email (this is how we will communicate the most with you) REQUIRED Please fill out this field. Please enter an email address.

Primary Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Home Address Please enter valid data.

City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.

Are you a parishioner of The Cathedral of Our Lady of Walsingham? REQUIRED yes no Please fill out this field.

How did you hear of Holy House Academy? REQUIRED Please fill out this field.

How many years have you been homeschooling? (If less than a year, please let us know why you decided to start) Please enter valid data.

Mom's Name Please enter valid data.

Mom's degree/teaching interest/talents Please enter valid data.

Dad's Name Please enter valid data.

Dad's degree/teaching interest/talents Please enter valid data.

Number of children who could attend Holy House Academy REQUIRED Please fill out this field.
Child 1
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Grade level completed or to be completed at the end of the current academic year REQUIRED Please fill out this field.
- Gender Male Female
- Date of birth REQUIRED Please fill out this field. Please enter a date.
Child 2
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Grade level completed or to be completed at the end of the current academic year REQUIRED Please fill out this field.
- Gender Male Female
- Date of birth REQUIRED Please fill out this field. Please enter a date.
Child 3
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Grade level completed or to be completed at the end of the current academic year REQUIRED Please fill out this field.
- Gender Male Female
- Date of birth REQUIRED Please fill out this field. Please enter a date.
Child 4
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Grade level completed or to be completed at the end of the current academic year REQUIRED Please fill out this field.
- Gender Male Female
- Date of birth REQUIRED Please fill out this field. Please enter a date.
Child 5
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Grade level completed or to be completed at the end of the current academic year REQUIRED Please fill out this field.
- Gender Male Female
- Date of birth REQUIRED Please fill out this field. Please enter a date.
Child 6
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Grade level completed or to be completed at the end of the current academic year REQUIRED Please fill out this field.
- Gender Male Female
- Date of birth REQUIRED Please fill out this field. Please enter a date.
Child 7
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Grade level completed or to be completed at the end of the current academic year REQUIRED Please fill out this field.
- Gender Male Female
- Date of birth REQUIRED Please fill out this field. Please enter a date.

Questions or comments? Please contact Rebecca Hill ([email protected])

Request for Enrollment or Information

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Holy House Academy Request for enrollment or information form