Hawthorn Leadership School for Girls

Complete an Application

  • Copies of the following documents must accompany the attached completed application:

          • Your student’s immunization record must be from a physician or public health agency.
            Month/day/year is required for all immunization dates.
            Missouri law requires proper immunizations for children to enroll in or attend school.
            Immunizations for polio, DPT, measles, mumps, and rubella (MMR) and hepatitis B are required.
            In addition, varicella vaccine(s) or proof of disease (chickenpox) is required for students entering grades kindergarten through 9. Meningitis vaccine is required for students entering 8th grade.
            For students in grades 5 through 9, proof of disease shall be a signed note from the parent or licensed health provider within the month and year of the disease.
            If immunizations are needed, contact your primary care provider for an appointment as soon as possible.

          • Student Information

          • (mm/dd/yyyy)
          • PermanentTemporaryChild is Homeless
          • The City of St. Louis Public School District (SLPS)St. Louis County *Eligible to Attend Through School District via VICC ProgramNormandy Collaborative
          • MaleFemale
          • African AmericanCaucasianHispanicAsian/PacificAmerican IndianMulti-racial/Multi-ethnicOther
          • Parent/Guardian Information

            Parent/Guardian #1

          • Parent/Guardian #2

          • Please check this box if mailers should be sent to both addresses.
          • Sibling Information

            Sibling #1

          • Applying
          • Sibling #2

          • Applying
          • Sibling #3

          • Applying
          • Emergency Contact Information

            I authorize Hawthorn Leadership School for Girls to release my child, and information regarding my child, to the following adults:

          • I do not authorize Hawthorn Leadership School for Girls to release my child to the following individual:

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          • I have been made aware that HLSG requires students to wear uniformsI have been made aware that HLSG does not provide transportation
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          • Home Language Survey

          • FemaleMale
          • Less than 1 yearMore than 1 year, but less than 3 years3 years to 5 yearsMore than 5 years
          • YesNo
          • Understands only EnglishUnderstands only the home languages listed aboveUnderstands both English and the home language
          • EnglishHome languageUnderstanding Equal
          • EnglishHome language listed above
          • EnglishHome language listed above
          • EnglishHome language listed above
          • YesNo
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          • Homeless or Migratory Status

          • YesNo
          • YesNo
          • YesNo
          • YesNo
          • YesNo
          • Migratory Status

            If you have moved from one school district to another in the past six years, please answer the following questions to help us determine whether your child is eligible for a special program of supplemental services:

          • YesNo
          • Examples of Agricultural Work: planting or harvesting crops (vegetables, fruits, cotton, etc.); landscaping; transporting farm products to market; feeding poultry; gathering eggs, working in hatcheries, processing poultry, beef, hogs, fruit, vegetables, etc; working on a dairy farm or a catfish farm; cutting firewood or logs to sell.

          • YesNo
          • YesNo
          • YesNo
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          • Student Services Intake Information

            Hawthorn Leadership School for Girls is fully committed to providing quality education to all of our students, including those with special needs. In order to do this, we need your help. Please complete this section in its entirety.

          • Previous School Information

          • PublicCharterPrivateParochialHome SchoolOther
          • YesNo
          • YesNo
          • YesNo
          • Special Education and Disability Accomodation

          • YesNo
          • YesNo
          • YesNo
          • YesNo
          • YesNo
          • Speech and LanguagePhysical TherapySelf-Contained ClassroomInclusion ServicesOrientation and MobilityAdapted Physical EducationOccupation TherapyCounselingDeaf and Hard of HearingVisually ImpairedMedical ServicesResource Room
          • YesNo
          • YesNo
          • YesNo
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          • Student Discipline Statement

            In accordance with the Missouri Safe Schools Act, parents, guardians and other persons having charge or control of a student must provide Hawthorn Leadership School for Girls information regarding the student’s disciplinary and criminal history prior to admission.

          • YesNo
          • YesNo
          • YesNo
          • First degree murder under 565.020, RSMoSecond degree murder under 565.021, RSMoFirst degree assault under 565.050, RSMoForcible rape (as it existed prior to August 28, 2013) or rape in the first degree under 566.030, RSMoForcible sodomy (as it existed prior to August 28, 2013) or sodomy in the first degree under 566.060, RSMoStatutory rape under 566.032, RSMoStatutory sodomy under 566.062, RSMoRobbery in the first degree under 569.020, RSMoDistribution of drugs to a minor under 195.212, RSMoArson in the first degree under 569.040, RSMoKidnapping, when classified as a class A felony under 565.110, RSMo
          • I attest that all the above information is correct and true. I understand that it is a crime pursuant to 167.023 RSMo. if I do not disclose the information requested or if I provide false information.

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          • Emergency Information and Medical Treatment Release

          • (mm/dd/yyyy)
          • I give Hawthorn Leadership School for Girls permission to seek medical treatment for my child in the event of a medical emergency. I will be responsible for the cost of any emergency medical care provided to my child.

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          • Student Health Information

          • (mm/dd/yyyy)
          • MaleFemale
          • YesNo
          • If yes, please list allergy. Note level of intensity and any medication used:

          • MildModerateSevereDelayed
          • MildModerateSevereDelayed
          • MildModerateSevereDelayed
          • YesNo
          • YesNo
          • YesNo
          • HepatitisDiptheriaMeningitisCleft PaletteHay Fever (handicap)Head InjuryOCD/ODDRheumatic FeverMeasles (regular)MumpsConvulsionsHeart ProblemSickle Cell AnemiaBipolar DisorderNeck InjuryMeasles (3 day)Whooping CoughDiabetes (sugar)HerniaBleeding TendenciesMigraines/HeadachesBone/Joint InjuryUlcerAsthmaEczemaTuberculosisTrouble with kidneysNeurological DisorderDigestive/Bowel problemsHigh Blood PressureCerebral PalsyEpilepsy or seizuresOrthopedic DefectEar, nose and throat problemsEmotions/PsychologicalOther
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          • Request for Records

            Your signature grants the sending school permission to forward your child’s school records to Hawthorn Leadership School for Girls.

          • To: School's Record Clerk

          • (mm/dd/yyyy)
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          • This student has submitted papers to Hawthorn Leadership School for Girls for the

          • Please provide copies of the student’s cumulative record, including health records, report cards, attendance records, discipline records, special education reports, IEP’s, 504 plans, primary language, and standardized test scores.

            The State of Missouri requires that any school district that receives a request for such records from another high school district enrolling a pupil that had previously attended a school in such district all respond to such request within five business days of receiving request.

            Please forward the above documentation to:
            Hawthorn Leadership School for Girls
            1901 N. Kingshighway Blvd.
            St. Louis, MO 63113
            Fax: 314-367-2035

          • RadioNewspaperTVMailingFlyerPhone CallWebsitePoster/BillboardMeetingDoor-to-DoorTable at Community EventReferredOther
          • VIP BreakfastField DayLibrary VolunteerProject Based Learning review panelParent Communication SupportParent Education Series SupportOther
          • Would you like to be included in a school directory "Buzz Book"? If so, please provide the information you would like us to include:

          • Media Consent and Release Form

            Throughout the school year, the media may visit the Hawthorn Leadership School for Girls to cover special events. The Hawthorn Leadership School for Girls may also wish to use your child’s photograph, likeness, voice or student work for promotional and educational reasons. Before your child’s photograph, likeness, voice, or student work can be used the by the media or by the school, you must give permission.

            I hereby consent to have

          • photographed, videotaped, audio taped, or interviewed by the Hawthorn Leadership School for Girls (“Hawthorn”) or the news media when school is in session or when my child is under the supervision of Hawthorn. I understand in the course of the above-described activities that Hawthorn might like to celebrate my child’s accomplishments and work. Therefore, I further consent for Hawthorn’s release of information on my child’s name, academic/non-academic awards and information concerning my child’s participation in school-sponsored activities, organizations and athletics.

            I also consent to Hawthorn’s use of my child’s name, photograph or likeness, voice or creative work(s) on the Internet or on a CD or any other electronic/digital media or print media.

            As the child’s parent or legal guardian, I agree to release and hold harmless Hawthorn, its members, trustees, agents, officers, contractors, volunteers and employees from and against any and all claims, demands, actions, complaints, suits or other forms of liability that shall arise out of or by reason of, or be caused by the use of my child’s name, photograph or likeness, voice or creative work(s), on television, radio or motion pictures, or in the print medium, or on the Internet or any other electronic/digital medium.

            It is understood and I do agree that no monies or other consideration in any form, including reimbursement for any expenses incurred by me or my child, will become due to me, my child, our heirs, agents, or assigns at any time because of my child’s participation in any of the above activities or the above-described use of my child’s name, photograph or likeness, voice or creative work(s).

            I understand that I may cancel my consent by providing written notice to the principal.

            This form is valid during the

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          • I do not consent to my child being photographed, videotaped, and/or interviewed by Hawthorn of the news media when school is in session or when my child is under the supervision of Hawthorn. I do not consent for Hawthorn to use creative work(s) generated and/or authorized by my child on television, radio or motion pictures, or in the print medium, or on the Internet or any other electronic/digital medium.
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          Schedule a VisitIs Hawthorn Right for You?

          We encourage community friends, prospective students and families to visit us! Throughout the year, our students lead tours twice a month during the school day which is a great way to see school in action. During student recruitment season, prospective families can attend our Saturday Open Houses. We also offer Family Tours the first Tuesday of every month during the spring.

          Visit Hawthorn