2025 Summer School Enrollment Form

Hartville R-II Summer School Enrollment Form

May 27-June 20, 2025 Tuesday-Friday each week
Name*

FirstMiddleLast
Date of Birth:*

MonthDayYear
Date
MaleFemale
Grade entering Fall 2025:*
High School ONLY: Course Selection:
Parent/Guardian Name*
Physical Address*
Mailing Address
City
State
Zip
Home Phone*
Format: (000) 000-0000.
Cell Phone
Format: (000) 000-0000.
Email Address
example@example.com
Emergency Contact
Phone
Format: (000) 000-0000.
YesNo
Name of driver during regular school year
Bus Number
ParentGuardian Signature

Clear
**New students' parent/guardian must complete the regular school enrollment

form in addition to the Summer School Enrollment.

Please complete this form no later than May 1st
Should be Empty: