To thank you for your referral, parents will receive $250* for each student referred to us and enrolled during the 2015 – 2016 school year! To participate, fill out the information below and return it to the Admissions Office anytime this summer or email the prospective family contact information to admission@chapel-hill.org

First Name_________________________________ Last Name_______________________________(Father)

First Name_________________________________ Last Name_______________________________(Mother)

Student: First Name____________________________ Last Name____________________________Grade _______

Street Address_____________________________________________________City_______________________________

State______ Zip____________ Phone__________________________ Email____________________________________

Referred by (full name)___________________________________ Phone/Email_______________________________

My friend/family would like to connect in the following ways (please select all that apply):

*The student must be enrolled for at least half of the school year. More than one student enrolling from a family will result in a $250 credit for each newly referred student enrolled from that family. For referrals enrolled in the fall of

2015-16, credits will be applied in January 2016 to confirm enrollment. Limit of only one credit per referred student.

For more information, contact the Office of Admission at 952-949-9014 ext. 118

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