• collage of therapy students
  • A photo of two young hippotherapy students being led around the farm on horseback.
  • photo of hippotherapy class

Agency Enrollment Form

You must agree to the program polices before submitting this form. If you have not yet read them please do so here.

Agreement

I have read and agree to the Program & Payment Policies.

I have downloaded and intend to mail/fax/email the Required Documents (click to download PDF) to Carlisle Academy for the current school year.

 

Agency Contact Information

Agency Name:

Contact:

Address:

City:

State:

Zip:

Phone:

Email:

 

Program & Tuition

Class Name:

Registration Deadline:

6 or 12 Week Session: SpringSummerFall

Tuition:

Pro-rations/Discounts: NoYes

 

Financial Aid

Scholarship pending with Carlisle Charitable Foundation? NoYes

Amount requested:

 

Terms

This registration form must be received by the registration deadline. If we do not receive it by this deadline we cannot guarantee you a spot in the program.

All agencies will be invoiced during the session once all other forms of payment have been determined.

 

Scheduling

Please indicate the day of the week and the time of day you would like to attend.
Wednesday - AMWednesday - PMThursday - AMThursday - PM

Specific time parameters:

Dates unable to attend: (tuition still applies unless excused absence)

Please list students names and conditions:

 

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