Madelaine Halmos Academy Current Student and Jack & Jill VPK Enrollment

MHA Re-enrollment Form (for current MHA or Jack & Jill Center VPK Students)

Thank you for your interest in re-enrolling your student(s) at the Madelaine Halmos Academy! We believe that innovative instruction and intentional family engagement positions our students to be tomorrow’s leaders.

To enroll your Jack & Jill VPK student or current Madelaine Halmos Academy student for the 2023-2024 school year, please complete our online application below. Once received, someone from our school will be in contact with you to discuss next steps. Please be advised there is an annual registration fee of $75.00 that will be charged to your account. The $75.00 registration fee is per family and covers all children currently enrolled at Jack and Jill Center and MHA.

MHA Re-enrollment Form for Current Elementary and Jack & Jill VPK students

Entering Grade in 2023-2024*
Student Information
Name*
First Name Last Name
Gender*
Date of Birth*
MM slash DD slash YYYY
Address*
Street Address City State ZIP Code
Would you like to register another student living at the same address?
Student 2 Grade in 2023-2024
Name
First Name Last Name
Gender
Date of Birth
MM slash DD slash YYYY
Parent/Guardian 1
Parent/Guardian 1*
Name*
Prefix First Name Last Name
Email*
Address (if different from above)
Street Address City State ZIP Code
Primary Phone*
Primary Phone Type*
Secondary Phone
Secondary Phone Type
Employer*
Parent/Guardian 1 Occupation*
Parent/Guardian 2
Parent/Guardian 2
Name
Prefix First Name Last Name
Email
Address (if different from above)
Street Address City State ZIP Code
Primary Phone
Primary Phone Type
Parent/Guardian 2 Secondary Phone
Secondary Phone Type
Employer
Occupation
Siblings Currently at Jack & Jill Center or Madelaine Halmos Academy
Name and age of brother/sister
School attending
Grade entering
Do you want to add a 2nd sibling?
Name and age of brother/sister 2
School attending 2
Grade entering 2
Do you want to add a 3rd sibling?
Name and age of brother/sister 3
School attending 3
Grade entering 3
Do you want to add a 4th sibling?
Name and age of brother/sister 4
School attending 4
Grade entering 4
The Madelaine Halmos Academy has an “Open Admission Policy” without discrimination as to race, religion, ethnic origin, gender and other protected categories.
Full Name of Parent/Guardian Submitting Form:*
Date*
MM slash DD slash YYYY
Comments
This field is for validation purposes and should be left unchanged.

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MHA Re-enrollment Form (for current MHA or Jack & Jill Center VPK Students)

MHA Re-enrollment Form for Current Elementary and Jack & Jill VPK students

Student Information

Parent/Guardian 1

Parent/Guardian 2

Siblings Currently at Jack & Jill Center or Madelaine Halmos Academy