Hillcrest Elementary (Portuguese)
Dual Language Immersion Program Application

Student Name *
Student Name
Date of birth *
Date of birth
Gender *
Applying for school year
Does this student have a twin or triplet? *
Student's primary language *
Does the student have a sibling currently enrolled in the Dual Immersion Program *
Parent/Guardian Information
Parent Phone *
Parent Phone
2nd Parent Phone (if applicable)
2nd Parent Phone (if applicable)
Has your child previously attended a full year in an immersion program? *
If not selected would you like to be placed on a wait list? *
Conditions and Consent
I have read and understand the conditions associated with this program. I understand that this application is not a guarantee of placement in the program.
Date *
Date