Join Us! – JHD Academy

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Registration Form

Please complete our registration form, and we will contact you within 24 hours.

Student Name

First

Last

Address

Address Line 1

Address Line 2

City

State

Zip Code

School / School District

DOB / Age

Grade

Parent or Guardian Name

First

Last

Emergency Email (if

Address (if different from student's)

Address Line 1

Address Line 2

City

State

Zip Code

Phone

Emergency Contact Name

First

Last

Emergency Contact Phone

Any Questions or Concerns

Special thanks to Lewis Management Corporation and the Homecoming at the Preserve Staff for Unwavering Support.

Other Affiliates:

Building Strong Voices
Builds Stronger Communities.

Contact Info

(951) 416-0450 - Main Office

(877) 909-1775 - Toll Free

(951) 755-9221 - Fax

admissions@jhdacademy.org

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Registration Form

Special thanks to Lewis Management Corporation and the Homecoming at the Preserve Staff for Unwavering Support.

Other Affiliates:

Contact Info

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