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Request Information

Thank you for your interest in our school!

Please complete the form below to set up your family record in our database. Our Admissions Director, Kathy Leitnick, will contact you from time to time and provide you with upcoming events that you can attend to learn more about our school.

* Indicates a required field.

Parent / Guardian Information
  • First Parent / Guardian
  • Last Name *
  • First Name *
  • Email Address *
  • Cell Phone
    (Ex: 999-999-9999)
  • Second Parent / Guardian
    (leave blank if not applicable)
  • Last Name *
  • First Name *
  • Email Address *
  • Cell Phone
    (Ex: 999-999-9999)
Home Address
  • Street Address *
  • City *
  • Country *
  • State *
  • Zip *
  • Home Phone
    (Ex: 999-999-9999)
  • How Did You Hear About Us?
    Details:
  •  
  • Student 1
  • First Name *
    Last Name *
  • Birthdate *
    (mm/dd/yyyy)
    Gender *
    Male    Female
  • Grade Level of Interest *
    School Year *
  • Current School
  •  
  • Is There Another Student?
    Yes No
  •  
  • Parent / Guardian Notes
  •