Certification of Racial Nondiscrimination for Evangelical Lutheran Church in America Early Childhood Education Centers

Hill and Dale Child Development Center admits students of any race, color, national and ethnic origin to all the rights, privileges, programs and activities generally accorded or made available to students at the school. It does not discriminate on the basis of race, color, national or ethnic origin in administration of its educational policies, administration policies, scholarship programs, or other school-administrated programs.

Hill and Dale is asking all families to complete this form in order to comply with Revenue Procedure 75-50 which requires all private organizations that operate tax-exempt schools to establish annual certification on racial nondiscrimination and maintain records of racial composition of students each academic year.

This form will be available to authorized personnel for research and reporting purposes only.

Your choice not to complete this form will not adversely affect your child's enrollment.

Please select one or more that best applies to you.

Ethnicity


Race