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Role
Are you the: Parent   Student  
Email:
Guardian Information
Name of parent:
Student Information
First name:
Middle name:
Last name:
Student date of birth:
Student is: Male   Female  
Currently in grade:
Seeking entry for grade:
Target start date:
Name of current school:
School type: Public   Private   Parochial  
Applying for financial aid?: Yes   No   Don't Know  
About the Student

Please describe academic, athletic, and extracurricular interests of the student.

Address and Telephone Number
Address:
City:
Country:
State:
Zip:

(enter "N/A" if not applicable)
Phone:

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