Application for Infant Program

Please fill in all information. Home, work and cell phone numbers and emergency contact information are essential; please review your application for omissions. Please provide a complete “Preferred Email Address” to receive LHS correspondence; list only one address in this field. Fields marked with a ” * ” need to be completed to submit your application.

Application is
For School Year
Applicant First Name*
Applicant Last Name*
Applicant Date of Birth*
Age in Months*
Sex **
- Male
- Female
First Language
- English
- Other
Applicant First Language if other specify
Applicant Second Language
Applicant Street Address*
Applicant Town*
Applicant State*
Applicant Zip Code*
Applicant Home Phone*
Applicant School District*
Applicant School District if other specify
Applicant Country of Birth*
Applicant Country of Citizenship*
Applicant If Not A US Citizen Number Of Years In USA
Application For Infant Programm
Applying for Infant Program*
Infant Program Program Applying For*
Infant Program Session Selected*
5 Day School Calendar 8:00am-3:00pm (Follows regular school calendar)
5 Day School Calendar 9:00am-4:00pm (Follows regular school calendar)
5 Day School Calendar 7:30am-6:00pm (Follows regular school calendar)
5 Day Extended School Calendar 8:00am-3:00pm (Provides more days of child care)
5 Day Extended School Calendar 9:00am-4:00pm (Provides more days of child care)
5 Day Extended School Calendar 7:30am-6:00pm (Provides more days of child care)
"School Calendar" sessions follow the regular Laurel Hill School calendar.
"Extended Calendar" sessions provide school days through several major vacation periods.
School History
Current School/Daycare Center
Parent / Guardian 1
Parent / Guardian 1 First Name*
Parent / Guardian 1 Last Name*
Parent / Guardian 1 Relationship*
Parent / Guardian 1 Street Address*
Parent / Guardian 1 Town*
Parent / Guardian 1 State*
Parent / Guardian 1 Zip Code*
Parent / Guardian 1 Home Phone*
Parent / Guardian 1 Business Phone*
Parent / Guardian 1 Cell Phone*
Mothers Home Phone*
Mothers Business Phone*
Mothers Cell Phone*
Father Home Phone*
Father Business Phone*
Father Cell Phone*
Parent / Guardian 1 Email*
Parent / Guardian 1 Occupation
Parent / Guardian 1 Employer
Parent / Guardian 1 Business Address
Parent / Guardian 2
Parent / Guardian 2 First Name
Parent / Guardian 2 Last Name
Parent / Guardian 2 Relationship
Parent / Guardian 2 Street Address
Parent / Guardian 2 City
Parent / Guardian 2 State
Parent / Guardian 2 Zip Code
Parent / Guardian 2 Home Phone
Parent / Guardian 2 Business Phone
Parent / Guardian 2 Cell Phone
Mothers Home Phone
Mothers Business Phone
Mothers Cell Phone
Fathers Home Phone
Fathers Business Phone
Fathers Cell Phone
Parent / Guardian 2 Email
Parent / Guardian 2 Occupation
Parent / Guardian 2 Employer
Parent / Guardian 2 Business Address
Parents' Status
Parents Marital Status
Parents Marital Status if other specify
LHS must be provided with court-issued custody papers that clearly describe any restricted or limited custody arrangements. Any person granted custody in such papers may pick up the child during the times that person has custody, and may designate other persons who are authorized to pick up the child at such times, unless court papers state otherwise.
Parents Status Applicant Resides With
Parents Status Applicant Resides With if other specify
Parents Status Preferred Email*
Emergency Contact & Physician
Emergency Contacts First Name*
Emergency Contacts Last Name*
Emergency Contacts Street Address*
Emergency Contacts Town*
Emergency Contacts Home Phone*
Emergency Contacts Business Phone
Emergency Contacts Cell Phone*
Emergency Contacts Applicants Physician*
Emergency Contacts Physicians Phone*
Student Profile
Does your child have any allergies?*
- Yes
- No
*
Student Profile Special Health Needs
Student Profile Additional Comments
Terms, Policies and Conditions*
- I agree to all Terms, Conditions and Policies of The Laurel Hill School

Application for Infant Program

Application For Infant Programm

School History

Parent / Guardian 1

Parent / Guardian 2

Parents' Status

Emergency Contact & Physician

Student Profile

Welcome Back To School

LHS is a recognized New York State private school, located in Suffolk County, Long Island.

Parent Bravos

Here is a small sample of some of the beautiful comments from our Parents

From a 6th Grade Parent:

From a 3YR Old Parent: