Divine Providence Academy

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Welcome to our school! How can we help you today?

What would you like to learn about?

About the Student

Student's Name

First

Middle

Last

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Preferred Name

Gender

Date of Birth

mm/dd/yyyy

Select "Public School" if ONLY inquiring about before care, after care, or summer care.

Inquiring about Grade/Program

How many days would you like your child to attend?

Which days of the week are you interested in?

Monday

Tuesday

Wednesday

Thursday

Friday

Infants and Toddlers can choose up to ten hours a day anytime between 6:30am - 6pm for childcare.

Please select number of hours you would like for childcare:

Please indicate the hour range you would like for childcare:

Do you want before care from 6:30-7:30am?

Yes No

What time would your child be dropped off?

Do you want after care from 2:45-6pm?

Yes No

What time would your child be picked up?

Inquire about Campus

For the school year of

School Currently Attending

Please specify

About the Parents & Guardians

Name

Title

First

Middle

Last

Suffix

Preferred Name

Relationship to Student

Primary Phone

Type

Number

SMS Opt In By selecting yes, you are agreeing to receive informational SMS text messages from Divine Providence Academy. Notification frequency varies. Message & data rates may apply. To opt-out of all SMS notifications from this organization, select no or text STOP to 1-844-616-9635.

Yes No

Email Address

Address

Are you an alumni?

Yes No

Are you a registered member at a Catholic parish?

Yes No

Please Select Parish

Please specify

Please name your place of worship (if applicable)

Thanks for reaching out! Out of curiosity...

How did you hear about us?

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The information on this form will help our Admissions Office begin a conversation with you. Your information will only be used for Admissions purposes and will not be shared with any other organization. Upon submission, a member of our Admissions staff will contact you to follow up on your request and answer any questions you may have.