Harbor City School Application

196 Putnam Street, East boston, Massachusetts 02128

You MUST Submit before leaving this form or ALL entries will be lost.

Child

Enter the child's full name (example: use Joseph not Joe)

First name *

Middle names

Last name *

Preferred name 🛈

Gender *

Male

Female

Date of birth * +

Language spoken at home *

Siblings

Name

Date of birth +

Name

Date of birth +

Name

Date of birth +

Name

Date of birth +

Program

We offer two program options

5 days: Monday-Friday

3 days: Monday, Wednesday, Friday

Hours:

8:00 AM -4:30 PM September- June

8:00 AM-3:30PM July/August

Click here for our tuition schedule

Start date +

We require a $50 NON REFUNDABLE fee to process your application and to place your child on the waitlist. We will send you an invoice once we recieve your application through QuickBooks, where you can pay this fee online.

How did you hear about us? *

Parent or legal guardian

Title * 🛈

First name *

Last name *

Relationship to child *

Enter telephone number as 10 digits with no other characters

Primary telephone *

Type *

Email address *

Would you enrollment for 3 days a week, or full time? *

Full Time Enrollment

Monday Wednesday Friday