Inquiry Form
indicates required fields
Thank you for your interest in
Milton Hershey School
! Please take a few minutes to complete this form.
After submitting it, you will receive additional information from us in the mail in about 7 - 10 days.
Any questions? Don't hesitate to give us a call or send us a text at
717.647.5050
. We are here to help!
About the Student or Potential Applicant
Name
First
Middle
Last
Jr
Sr
II
III
IV
V
Suffix
Preferred Name
Gender
Date of Birth
mm/dd/yyyy
Please Note: Applicants who have already turned 16 are not eligible for enrollment.
Is this student a US Citizen or Permanent Resident who is lawfully permitted to permanently reside in the US?
Yes
No
Ethnicity
Hispanic or Latino
Not Hispanic or Latino
Race
White
Black or African American
Asian
American Indian or Alaska Native
Native Hawaiian or Other Pacific Islander
Current Grade (2023 - 2024 School Year)
Not yet in school
Pre-K
K
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Grade Apply (2024 - 2025 School Year)
Not yet in school
Pre-K
K
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
School Year (Please select 2024 - 2025)
2024 - 2025
Current School Name (if applicable)
Current School City and State (if applicable)
About the Parent/Guardian
Name
First
Middle
Last
Jr
Sr
II
III
IV
V
Suffix
Relationship to Student or Potential Applicant
Mother
Father
Stepmother
Stepfather
Grandmother
Grandfather
Guardian
Does this Parent/Guardian hold Legal Custody?
Yes
No
Phone (xxx-xxx-xxxx)
Cell
Home
Work
Type
Number
SMS Opt In
By selecting yes, you are agreeing to receive SMS text messages from Milton Hershey School. Notification frequency varies. Message & data rates may apply. To opt-out of all SMS notifications from this organization, select no or text STOP to 1-855-966-2022.
Yes
No
Email
Mailing Address
I agree to receive text messages from MHS.
Yes
No
I agree to receive email communication from MHS.
Yes
No
