2012-2013 Forms

Please make sure to have your correct Student ID available when filling out forms. Student IDs are located at the top left of your contracts. Forms without a valid Student ID will not be processed.

Required Forms For Each Student:
These necessary forms must be complete before your child can attend school or compete on an athletic team. Thank you for your cooperation in making sure these important issues are completed by Wednesday, August 1, 2012. Forms may be faxed to (918) 879-4798, mailed to the school to attention Linda Christensen, or dropped by the Admission Office.

I. REQUIRED HEALTH FORMS:

A. Student Emergency & Health Information Form for All New and Returning Students

For returning students, the Student Emergency & Health Information Form will be sent home via mail starting the week of April 16, containing the information the school currently has on file. Please review both the front and back of this form to confirm or modify your child/children’s information.

• If all information is correct, select the appropriate box at the bottom of the section, if applicable, and sign and date each of the (3) three sections.
• If information needs to be changed or updated, please mark through the information to be changed and write the correct information on the form and/or add any new information.  Select the appropriate box at the bottom of the section, if applicable, and sign and date each of the (3) three sections.

Please Note:  All (3) three sections MUST be signed to complete the form.

For new students, you will receive the form through the Admission Office. If you have any questions concerning this health form, please contact the school nurse at (918) 879-4714 or email nurse@hollandhall.org.

B. Download Physical Form for All New and Returning Students – All new students and returning students grades Kindergarten, 4th and 6-12 must provide a current physical dated April 1, 2012 or later.  

Holland Hall will offer free physicals to all students in 6th through 12th grades in the Upper School Commons on Sunday, May 20 from 3:00 p.m. to 6:00 p.m.  Girls’ physicals will begin at 3:00pm and boys’ physicals will begin at 4:00 p.m.

In order for 6th – 12th grade students to obtain a free physical, they must bring the following completed paperwork:

• The enclosed updated and signed Emergency & Health Information Form.
• A new mandatory Medical History form MUST be completed and signed by a parent. This form will be reviewed and signed by our physicians during the physicals. (Click and download item C below)

Students in Kindergarten and 4th grade are required to turn in a current physical from their personal physician. These students do NOT need a Medical History form.

Return Completed Forms by August 1, 2012. If your child is not going to participate in the free physical, please return the completed health forms by August 1, 2012 to the Admission Office, fax to 918-879-4798, or mail to:  Holland Hall, Attn: Director of Health Services, 5666 E. 81 St., Tulsa, OK 74137.

C. Download Mandatory Medical History form for Students 6-12 - All 6-12 grade students attending the free Holland Hall physical on May 20, must present a Medical History form complete and signed by a parent in order to obtain a physical. Students who choose not to attend the Holland Hall physical must have the Medical History and Physical form completed by their physician.

D. Download Mandatory Form for New and Returning Students (Grades 6-12) with Inhalers -  Please note, inhalers for all students under grade 6 must be kept in the appropriate division Nurse’s office.

E. New Students Only: Up-to-date Immunization Records From the Physician’s Office – (If not already submitted to the Admission Office.) Per Oklahoma State law, no child is allowed to begin school without current immunization records.

II. OTHER FORMS TO CONSIDER:

Online Primary School Extended Day Program Enrollment Form Please submit your online form no later than August 1, 2012 in order to secure a space for your child. Please note that our Early Birds program fills up quickly.

Online Middle School Extended Day Program Enrollment Please submit your online form no later than August 1, 2012 in order to secure a space for your child.

Bus Transportation Request Form Holland Hall is planning to offer our Bus Service for the 2012-2013 school year. In order to assess the needs for next year, we ask that you complete and submit your request as soon as possible. (IMPORTANT NOTE: A lack of riders may result in the cancellation of this service.)

Primary to Middle After School Transfer Request
If you have students in both the Primary and Middle Schools and would like to have your child(ren) walked to the Middle School at dismissal time, please complete the following form. (This service is not offered for students in our 3 year old PreSchool program.)

For questions regarding these Other Forms, please call 918.879.4722 or email mbp@hollandhall.org.