Western Academy

Inquiry

indicates required fields

Prospective Student's Information

Son's Name

First

Middle

Last

Preferred Name

Gender

Male

Date of Birth

mm/dd/yyyy

School Type

Current School

Current Grade

Entering Grade

For Academic Year

Please select a date/time:

Contact for this appointment

First Name

Last Name

Phone

Middle School Tours

Currently, we do not have availability for Middle School tours. Would you like to be placed on a callback list should a tour slot become available?

Yes No

Siblings

Do you have another Son you are considering sending to Western Academy?

Yes No

Son's Name

First

Middle

Last

Suffix

Preferred Name

Relationship to Prospective Student

Date of Birth

mm/dd/yyyy

Current School

Current Grade

Entering Grade

In Fall of

Do you have another Son you are considering sending to Western Academy?

Yes No

Son's Name

First

Middle

Last

Suffix

Preferred Name

Relationship to Prospective Student

Date of Birth

mm/dd/yyyy

Current School

Current Grade

Entering Grade

In Fall of

Household Information

Home Address

Parent Information

Your Full Name

Title

First

Middle

Last

Suffix

Preferred Name

Relationship to Son

Primary Email

Primary Phone Number

Type

Number

SMS Opt In By selecting yes, you are agreeing to receive informational SMS text messages from Western Academy. Notification frequency varies. Message & data rates may apply. To opt-out of all SMS notifications from this organization, select no or text STOP to 1-833-572-0304.

Yes No

Occupation

Employer

Are you married?

Yes No

Spouse's Information

Your Spouse's Full Name

Title

First

Middle

Last

Suffix

Preferred Name

Relationship to Son

Occupation

Employer

Thanks for reaching out! Out of curiosity...

How did you hear about Western Academy?

Feel free to add any information you think we should know.

Why are you considering sending your son(s) to Western Academy?