Enrollment Application Please detach this form and mail a $50 non-refundable deposit to secure a spot on the waiting list. Please make checks payable to HACNS and mail to: HACNS Membership Coordinator P.O. Box 170238 San Francisco, CA 94117 Date Submitted:
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Name of Child: (Please note if child is a sibling of an alumni) Male / Female (please circle)
Birthdate:
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Year you are applying for: Siblings and their ages: Will a sibling join you on your work day?:
Parent Name(s): Address:
Phone:
Email:
Any other information you believe is important to include: