HLS Northeast Wisconsin Application Form

Application Form

2025-2026 Academic Year
Family Information
Mother's name*

First NameLast Name
Mother's phone*

Area CodePhone Number
Mother's email*
example@example.com
Mother's highest degree or level of education*
Mother's employer and position (if applicable)
Father's name*

First NameLast Name
Father's phone*

Area CodePhone Number
Father's email*
example@example.com
Father's employer and position (if applicable)
Father's highest degree or level of education*
Marital status*

MarriedDivorced or seperatedWidowed
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Children in household*
Please include a family photo. *

Browse Files

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Church affiliation*
How did you hear about HLS Northeast Wisconsin?*
Do you know families who have students enrolled HLS Northeast Wisconsin? If so, please list them here.*
What led you to apply to HLS Northeast Wisconsin?*

Student Information
Please list each student applicant to HLS Northeast Wisconsin.*
Please describe each student's education history (schools or co/ops attended, curriculum, classes, etc.). Add a line and specify each student as applicable.*
Please describe each student's extracurricular interests and/or achievements. Add a line and specify each student as applicable.*
Have one or more of the students:*

Been tutoredRepeated a gradeHad learning difficulties or received academic accommodationsHad behavioral, anxiety, or attention difficultiesBeen subject to disciplinary actionBeen diagnosed with a serious illness or physical, mental, or emotional disabilityNone of the above
If you checked one or more of the above, please list each student and explain.

Do you have student applicants applying to the Simply Classical (special needs) track?*

YesNo

Additional Student Information (Simply Classical)

We would like to get to know your child more to best serve them in the Simply Classical program.
Please describe the student's interests and strengths. If you have more than one applicant to Simply Classical, please add a line and specify each child as applicable.*
Please describe your child's biggest obstacles as they pertain to socialization and learning. If you have more than one applicant to Simply Classical, please add a line and specify each child as applicable.*
Please describe your child's possible triggers and/or behaviors. If you have more than one applicant to Simply Classical, please add a line and specify each child as applicable.*
Please list any formal diagnoses and/or evaluations your child has received and include date(s). If you have more than one diagnosis/child, please add a line and specify each diagnosis/child as applicable.*
Does your child have a history of elopement and/or self-harm? If so, please describe. If you have more than one applicant to Simply Classical, please add a line and specify each child as applicable.*
Does your child currently receive any therapies (e.g., ABA, OT, SP, PT, etc.)? How often (i.e., times per week/month/etc.)? How long has your child received therapy? If you have more than one applicant to Simply Classical, please add a line and specify each therapy/child as applicable.*
Do you desire for your child(ren) to have an ABA therapist or Personal Care Assistant (PCA) in the classroom? Please know that a desire does not obligate us to provide one.*

YesNoNot applicable
Please list the name of the provider, phone number of the facility/clinic, and the name of the therapist or PCA. If you have more than one provider and/or child, please add a line and specify each provider/child as applicable.*
Do we have your permission to contact your service facility/clinic and discuss the needs and recommendations for your child(ren)?*

YesNoNot applicable
Is your child able to remain in a classroom setting for extended periods of time? If you have more than one applicant to Simply Classical, please add a line for each child.*
Is your child responsive to and respectful of adults? If you have more than one applicant to Simply Classical, please add a line for each child.*
Is your child disruptive and resistant to correction? If you have more than one applicant to Simply Classical, please add a line for each child.*
Does your child have a history of significant behavioral difficulties in other educational settings? If you have more than one applicant to Simply Classical, please add a line for each child.*
Is your child(ren) supported at home with parents or guardians who are willing to teach and conduct lessons, practice, and/or assignments from the Simply Classical curriculum?*

YesNo

Curriculum Experience
Please list the curriculum you have used for composition/writing and the highest level your student has completed, if applicable. If you have additional students, please add a line.
Please list the curriculum you have used for Latin and the highest level your student has completed, if applicable. If you have additional students, please add a line.
Please list the curriculum you have used for math and the highest level your student has completed, if applicable. If you have additional students, please add a line.

Additional Documents

We have a few more things we need from you to complete your application form.
We ask that you please submit the following for all students, as applicable:

1. Report card

2. A teacher contact from the past year that we may contact for more information. You may also provide the contact information of a coach, Sunday School teacher, music teacher, dance instructor, etc.

You may upload the documents or email them to:

information@highlandslatin.org
Upload files for report card(s) here, as applicable.

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Please list teacher reference information below, if applicable. To list another student and reference, please add a line.
If there are any points of philosophy or school policy which are inconsistent with your goals for your family, please explain briefly here.
Do you have questions about any of the curriculum or school policies?

Code of ConductUniformsCurriculumStatement of FaithNone
Please provide your questions below and we will be in touch with you to discuss them further.
There is a non-refundable application fee of $50 per student for the traditional program and $75 per student for the Simply Classical program. If you are paying by check, please make it out to: Northeast Wisconsin Latin Cottage School.

Please submit your application fee to:

HLS Northeast Wisconsin

P.O. Box 4

Greenville, WI 54942

If you would like to submit your application fee online, please fill out the information below. Note that there is a transaction fee (2.9% + $0.30) to complete your payment online, which is reflected in the pricing below.

Application Fee - Traditional Program$51.45

(includes 2.9%)

Quantity

Application Fee - Simply Classical Program$77.17

(includes 2.9%)

Quantity

Stripe transaction fee$0.30

Total $0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Should be Empty:

Family Information

Student Information

Additional Student Information (Simply Classical)

Curriculum Experience

Additional Documents