Summer Portals Inquiry Form

Thank you for your interest in our Summer Programs.

Student Information

Please choose *

Student First Name *

Middle Name

Student Last Name *

Preferred Name/Nickname (optional)

Gender *

Birthdate *

I would consider residential programming.

Yes

No

I would consider online programming.

Yes

No

I would consider day student programming.

Yes

No

Please share any additional academic programs that you would like to see offered
at Hotchkiss Summer Portals.

Please list any relatives who attended Hotchkiss or Hotchkiss Summer Portals:

Contact Information

Permanent Address *

Country

Street

City

Region

Postal Code

Home Telephone *

Preferred Student Email Address *

Current Grade *

School Name *

Family Information

Relationship 1 *

Parent 1/Guardian First Name *

Parent 1/Guardian Last Name *

Parent 1/Guardian Email *

Parent 1/Guardian Mobile Phone *

Relationship 2

Parent 2 First Name

Parent 2 Last Name

Parent 2 Email

Additional Information

How did you find out about Hotchkiss Summer Portals?