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Child Enrichment Center Application Form


School Year
Enrollment Date
Schedule
Child's Name
Nickname
Address
City
State
ZIP+4
Home Phone
Gender
Male
Female
Date of Birth
Age on September 1
Child will attend:
August through May
August through July
Child will attend the following holidays:
Thanksgiving
Christmas
Spring Break
Sibling(s) applying at Holy Spirit?
Grade(s)?
CEC?
Student’s religious affiliation
Parent Name
Relationship
Mother
Father
Other
If other, please describe
Address
City
State
ZIP
Home Phone
Work Phone
Cell Phone
Email
Employer
Permission to pick up child?
Yes
No
Responsible for payment?
Yes
No
Contact in emergency?
Yes
No
Lives with child?
Yes
No
Parent Name
Relationship
Mother
Father
Other
If other, please describe
Address
City
State
ZIP
Home Phone
Work Phone
Cell Phone
Email
Employer
Permission to pick up child?
Yes
No
Responsible for payment?
Yes
No
Contact in emergency?
Yes
No
Lives with child?
Yes
No
Other Family Member Name
Relationship?
Address
City
State
ZIP
Home Phone
Cell Phone
Email
Permission to pick up child?
Yes
No
Responsible for payment?
Yes
No
Contact in emergency?
Yes
No
List names and addresses of other people allowed to pick up child.
Has applicant had a professional educational or psychological evaluation?
If yes, please send a copy.
Yes
No
List names and addresses of other schools attended.
Media Permissions
Yes, HSES has permission to use my child’s picture for publications.
Water Activity Permission
Yes, my child has permission to participate in water activities.
The school admits qualified students of any race, color national or ethnic origin to all the rights, privileges, programs and activities generally accorded or made available to students at the school. It does not discriminate on the basis of race, color, national or ethnic origin in administration of its educational policies, admission policies, scholarships, athletic or other school administered programs.
 
In submitting this application for admission, I understand a NON-REFUNDABLE AND NON-TRANFERABLE $200.00 deposit must be submitted and that all later deposits and tuition payments are NON-REFUNDABLE AND NON-TRANSFERABLE. No employee or agent of Holy Spirit Episcopal School may authorize an exception to this policy.
  

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Holy Spirit Episcopal School 12535 Perthshire Rd, Houston, TX 77024Phone: 713-468-5138Email: hses@hses.org
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