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Fill out the form below to sign up for a program currently accepting registrations.
You will be contacted by a staff member to complete your registration

Select the program you want to enroll in

Applicant's Full Name*

Date of Birth*

Parent/Guardian Full Name*

Phone*

Email*

Does the applicant have any allergies?

Has the applicant completed high school or an equivalency diploma?

In a few sentences, describe why you would like to enroll into our program. *

Parent's consent at dismissal*Parent will be responsible for pickupStudent is allowed to leave on their own

Applicant Acknowledgment, Type Name Below*

Guardian Acknowledgment, Type Name Below*

I certify that my answers are true and complete to the best of my knowledge. I acknowledge submission of this application does not guarantee admission. Ihya Seminary reserves the right to withhold reason of rejection. If this application leads to acceptance, I understand that false or misleading information in my application or interview, may be subject to revocation.

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