Peabody School

04/26/24

Inquiring Student Information

Name

First

Middle

Last

Suffix

Preferred Name

Birth Date

mm/dd/yyyy

Gender

Inquiring about Grade

For Academic Year

Current Grade

Current School

Siblings of Inquiring Student

Does the above named student have any siblings, Pre-K through 6th Grade?

Please select:

Yes No

Sibling 1

Name

First

Middle

Last

Suffix

Preferred Name

Birth Date

mm/dd/yyyy

Relationship to Inquiring Student

Inquiring about Grade

For Academic Year

Sibling 2

Is there a second sibling?

Yes No

Name

First

Middle

Last

Suffix

Preferred Name

Birth Date

mm/dd/yyyy

Relationship to Inquiring Student

Inquiring about Grade

For Academic Year

Sibling 3

Is there a third sibling?

Yes No

Name

First

Middle

Last

Suffix

Preferred Name

Birth Date

mm/dd/yyyy

Relationship to Inquiring Student

Inquiring about Grade

For Academic Year

Sibling 4

Is there a fourth sibling?

Yes No

Name

First

Middle

Last

Suffix

Preferred Name

Birth Date

mm/dd/yyyy

Relationship to Inquiring Student

Inquiring about Grade

For Academic Year

Sibling 5

Is there a fifth sibling?

Yes No

Name

First

Middle

Last

Suffix

Preferred Name

Birth Date

mm/dd/yyyy

Relationship to Inquiring Student

Inquiring about Grade

For Academic Year

Household Information

Please provide the following information for the household in which the student primarily resides:

Mailing Address

Home Phone

Parent/Guardian Information

Parent/Guardian 1 Name

Title

First

Last

Suffix

Preferred Name

Relationship to Inquiring Student

Cell Phone

Work Phone

Email

Is there a second parent/legal guardian in this household?

Please select:

Yes No

Parent/Guardian 2 Name

Title

First

Last

Suffix

Preferred Name

Relationship to Inquiring Student

Cell Phone

Work Phone

Email

Campus Tours

Peabody School welcomes prospective parents for a tour of campus, and visitors have the opportunity to see our students and teachers in their classrooms. If you would like to schedule a tour, please indicate here and you will be contacted by our Admission Office. (Tours last approximately 45 minutes.) We look forward to meeting you!

Please select:

Yes No

How did you learn about Peabody School? (check all that apply)

Please specify: