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Request Information

Thank you for your interest in our school!

Please fill out the form below and our Enrollment Office will contact you to set-up a tour of our school.

* Indicates a required field.

Parent / Guardian Information
  • First Parent / Guardian
  • First Name *
  • Last Name *
  • Salutation *
  • Email Address *
  • Confirm Email Address *
  • Cell Phone *
Home Address
  • Street Address *
  • City *
  • Country *
  • State
    *
  • Zip
    *
  • Home Phone *
  • How Did You Hear About Us? *
    Details:

  • Does your student have an IEP or 504 plan?
    * Yes   No

  • Is your student currently toilet trained?
    * Yes   No

  • Has your student been diagnosed with behavior issues (i.e. outbursts, biting, profanity)?
    * Yes   No

  • If leaving a private school, do you owe money?
    * Yes   No

  • Has your student been treated or seen by a mental health professional?
    * Yes   No

  • Has your student been in for inpatient treatment for mental or psychological episodes?
    * Yes   No

  • Has your student ever been expelled or suspended from school?
    * Yes   No

  • Does your student have coping mechanisms or emotional support systems in place?
    * Yes   No

  • Does your student have any assessments or evaluations by a specialist?
    * Yes   No

  • Does your student have any specific academic achievements or challenges?
    * Yes   No

  • Does your student have any hearing or visual impairments?
    * Yes   No

  • If you answered YES to any of the above questions with the exception of toilet training, please elaborate. 
    *
  •  
  • Student 1
  • First Name *
    Last Name *
  • Birthdate *
    (mm/dd/yyyy)
    Gender *
  • Grade Level of Interest *
    School Year *
  • Current School
  •  
  • Is There Another Student?
    Yes No
  •  
  • Parent / Guardian Notes
  •