Request Information

Thank you for your interest in our school!

Please fill out the form below and our Admissions Office will contact you and provide the information you desire.

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Parent/Guardian Information
*First Parent/Guardian
Salutation *

First Name *

Middle Name

Last Name *
Email Address *

Gender

Male Female
Work Phone

(Ex: 999-999-9999)

Cell Phone

(Ex: 999-999-9999)
Second Parent/Guardian
Salutation

First Name

Middle Name

Last Name
Email Address

Gender

Male Female
Work Phone

(Ex: 999-999-9999)

Cell Phone

(Ex: 999-999-9999)
How Did You Hear About Us?

Details:
Home Phone *

(Ex: 999-999-9999)
Street Address
City
Country
State
Zip
Are you interested in our Learning Resource Center? (Very important, please click the link and read carefully) *

Yes No
We have not taken a tour of the campus. Please contact me to set up a day and time. *

Yes No
Student 1
First Name *

Middle Name

Last Name *
Birthdate

(mm/dd/yyyy)

Email Address

Gender

Male Female
Grade Level of Interest *

School Year *
Student Interests

Academics

Art History Language Arts Math Music Physical Education Science Spanish

Misc.

Accelerated Math Accelerated Reader Art Club Band Book Club Chorus Computers Drama Science Club Yearbook Youth/Children's Ministry

Sports

Boys Basketball Boys Soccer Boys Volleyball Cheerleading Girls Basketball Girls Soccer Girls Volleyball
Current School
Is There Another Student? Yes No
Parent/Guardian Notes