Excelsior Preparatory School admissions

Sneak Peek Open House Registration Form

Please join us at one of our Sneak Peek Open Houses!  Please fill out the following information so we know to expect you.

NOTE: Questions flagged with (*) are required

  1. Parent's Name*
    Mother's name is required
  2. Phone Number*
    Invalid Input
  3. Parent's Email*
    Please enter a valid email address
  4. Address
    Student's Home Address
  5. City
    Please enter City
  6. State / Region
    State is required
  7. Zipcode
    Zipcode is required
  8. Child's Name*
    Student's full name is required
  9. Child's Age*
    Please enter students Date Of Birth in the format mm/dd/yyyy
  10. Grade attending in Fall*

    Please select student's gender
  11. Date you will be attending:*

    Invalid Input
  12. How did you hear about us?
    Invalid Input
  13. Are you interested in receiving information about our summer program?
    Invalid Input
  14. *
    Please enter the two words in the box above