Online Application

Hope Creek Academy-Online Application
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Please note your application is not considered complete until the $75 fee is received.
Child's Name
NOTICE OF NONDISCRIMINATORY POLICY AS TO STUDENTS: Hope Creek Academy admits students of any race, color, national and ethnic origin, or sexual orientation, to all rights, privileges, programs, and activities, generally made available to students at the school. It does not discriminate on the basis of race, color, national and ethnic origin, or sexual orientation in administration of its educational and admissions polices, scholarship programs, and other school-administered programs.
Parent/Guardian Name
Parent/Guardian Email
Street #, Street Name, City, State, ZIP Code
(xxx) xxx-xxxx
(xxx) xxx-xxxx Do not provide if duplicate.
(xxx) xxx-xxxx Do not provide if duplicate.
Please provide a comprehensive list of other household residents: name, age, and relationship to student.
Parent/Guardian Name
For other parent/guardian, if needed
Parent/Guardian Email
For other parent/guardian, if needed
Street #, Street Name, City, State, ZIP Code. For other parent/guardian, if needed
(xxx) xxx-xxxx For other parent/guardian, if needed
(xxx) xxx-xxxx Do not provide if duplicate. For other parent/guardian, if needed
(xxx) xxx-xxxx Do not provide if duplicate. For other parent/guardian, if needed
For other parent/guardian, if needed
For other parent/guardian, if needed
Please provide a comprehensive list of other household residents: name, age, and relationship to student. For other parent/guardian household, if needed
Emergency Contact 1
Other than parent/guardian.
Emergency Contact 2
Other than parent/guardian.
Please provide a comprehensive list of student's previous school(s) and grades attended
Please provide a comprehensive list of student's medical conerns/allergies. If none type, N/A.
Please provide a comprehensive list of student's current medications. If none please type, N/A.
Please include place in the family system, personality, likes and dislikes, etc...
Examples: math, reading, spelling, writing, social skills, life skills (money, tying shoes, telling time)
Click or drag files to this area to upload. You can upload up to 4 files.