Preview Day Registration

* Where did you hear about Preview Day

PARENT INFO

Relationship to Student

* Parent First Name

* Parent Last Name

* Parent Email

* Parent Phone

* Are you a graduate of Brentwood Academy?

Yes
No

* Are you a Brentwood Academy Faculty/Staff Member?

Yes
No

* Do you have a student currently at Brentwood Academy?

Yes
No

* Country

* Street Address

* City

* State

Zip Code

STUDENT INFO

* Student First Name

* Student Last Name

* Gender

* Birthdate
(When using the calendar, use the << button go back a full year and the < button to go back a month)

* Current Grade

* Current School

* Grade Interested in Applying for

* Would you like to add another student?

Yes
No