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Request Information

Thank you for your interest in our school!

Please fill out the form below and our Admissions Office will contact you by phone or e-mail to provide more information. 

 

* Indicates a required field.

Parent / Guardian Information
  • First Parent / Guardian
  • First Name *
  • Middle Name
  • Last Name *
  • Salutation *
  • Email Address *
  • Confirm Email Address *
  • Gender
  • Cell Phone
Home Address
  • Street Address
  • City
  • Country
  • State
  • Zip
  • Home Phone *
  • How Did You Hear About Us? *
    Details:
  •  
  • Student 1
  • First Name *
    Middle Name
    Last Name *
  • Birthdate *
    (mm/dd/yyyy)
    Gender
  • Email Address
    Confirm Email Address
  • Grade Level of Interest *
    School Year *
  • Current School

  • Is the Student a US citizen?
    * Yes   No

  • Please specify if you are inquiring about living in the dorm or if you are a local student and would like to come for the day.
    *

  • Within the last 24 months has the student been inpatient with therapeutic care?
    * Yes   No

  • Does the student currently have an IEP or a 504 plan?
    * Yes   No
  •  
  • Is There Another Student?
    Yes No
  •  
  • Parent / Guardian Notes
  •