HCHC Inquiry Form

1

Which campus would you like to attend?* This field is required.

Frederick

Columbia

Baltimore

Umbrella Only

Undecided

2

Which program model are you interested in?* This field is required.

In-Person

Hybrid

Umbrella Only

3

What school year are you considering for enrollment?* This field is required.

4

What grade level is the primary student entering?

Sprouts (Ages 5–8)

Lower School (Ages 9–12)

Upper School (Ages 13–18)

5

Number of Students* This field is required.

A 20% sibling discount applies per additional child.

7

Parent/Guardian Full Name* This field is required.

First Name

Last Name

8

Parent/Guardian Email Address* This field is required.

example@example.com

9

Parent/Guardian Phone Number* This field is required.

Please enter a valid phone number.

10

Preferred Method of Contact* This field is required.

Email

Phone Call

Text Message

11

Does your child have any learning, developmental, behavioral, medical, or support needs that may affect their participation in a group classroom setting?* This field is required.

None

Speech or Language Impairment

Autism Spectrum Disorder

Learning Disability

Physical Disability

Down Syndrome

ADD, ADHD

Other

12

How did you hear about HCHC?* This field is required.

13

What next step are you prepared to take?* This field is required.

Schedule a consultation.

Begin the enrollment process.

Attend an orientation or open house.

I'd like for someone to contact me.

14

Opt-in