Middle School Visit Request Form

Please fill out the following information in order to schedule a day for your child to visit our Middle School.

Student's Full Name *

First

Middle

Last

Student's Date of Birth *

Student's Gender *

Preferred pronouns (optional)

Does your student prefer to be called by a name/nickname other than first name?

Your answer

Select a Date - 8:20am to 3:30pm *

We will be in touch to schedule your child's Middle School Visit Day.

Please sign in at Underhill, our main office.
Arrival time is 8:20am. Pickup time is 3:30pm.

Student's Current School *

Student's Current Grade *

Student's Interests

Please list some of your child's academic interests, extracurricular activities, and/or hobbies. This will help us pair your child with one of our student ambassadors.

Parent Name *

First

Middle

Last

Parent Phone Number(s) *

Please list all the phone numbers you can be reached at during the day that your child is shadowing at our school.

Parent Email Address *

Confirm Email

Please list the email address that you would like us to use to contact you.

Emergency Contact Person *

First

Last

Please list the name of someone we can contact in the case of an emergency if we are unable to reach you.

Emergency Contact Phone Number *

Allergy Information

Please list any allergies your child has that we need to know about.

Health/Medication Information

Please list any health information we need to be aware of, or if there are any medications your child needs to take while on our campus.

Phone

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Recommit Form Due by: Feb 7

Middle School Visit Request Form