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Inquiry Form-Thank You.

Request Information

Thank you for your interest in our school! St. Lillian Academy/Hope Academy offers unique learning opportunities for unique learners.  As a first step in our admissions process, we ask that families fill out the inquiry form.

Once completed, someone will contact you and provide you with information related to openings.

* Indicates a required field.

Parent / Guardian Information
  • First Parent / Guardian
  • First Name *
  • Last Name *
  • Email Address *
  • Confirm Email Address *
  • Cell Phone *
Home Address
  • Street Address *
  • City *
  • Country *
  • State
    *
  • Zip
    *
  • Home Phone *

  • What school year are you looking for placement for your child?
    *

  • What are your main areas of concern related to your child's educational needs? 
    *

  • Does Your Child Have a Current IEP or Evaluation
    *

  • Please add any diagnosis or current challenges
    *

  • How Did You Learn About St. Lillian Academy
    *

  • Please Select the Following Therapies You Are Interested In
    *

  • Educational Goals
    *
  •  
  • Student 1
  • First Name *
    Middle Name
    Last Name *
  • Birthdate *
    (mm/dd/yyyy)
    Gender
  • Grade Level of Interest *
    School Year *
  • Current School
  •  
  • Is There Another Student?
    Yes No
  •  
  • Parent / Guardian Notes
  •