University Lake School

Tell us About Your Student

Name

First

Middle

Last

Suffix

Preferred Name

Gender

Date of Birth

mm/dd/yyyy

Current Grade

Interested in Grade

Student email address:

Preferred Program

Preferred Number of Days:

For the Fall of

Current School

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Would you like our help navigating through the financial aid process?

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About the Parent/Guardian

Name

Title

First

Middle

Last

Suffix

Preferred Name

Relationship to Student

Primary Phone (xxx-xxx-xxxx)

Type

Number

Secondary Phone (xxx-xxx-xxxx)

Type

Number

Email

Mailing Address

Sibling Information

How many siblings, if any, does the applicant have?

Sibling 1

Name

First

Middle

Last

Preferred Name

Relationship to Student

Date of Birth

mm/dd/yyyy

Grade

Sibling 2

Name

First

Middle

Last

Preferred Name

Relationship to Student

Date of Birth

mm/dd/yyyy

Grade

Sibling 3

Name

First

Middle

Last

Preferred Name

Relationship to Student

Date of Birth

mm/dd/yyyy

Grade

Sibling 4

Name

First

Middle

Last

Preferred Name

Relationship to Student

Date of Birth

mm/dd/yyyy

Grade

Broadening Horizons

Thanks for reaching out! Out of curiosity...

How did you hear about University Lake School?