Admissions: Inquiry Form

Student's name:

 

M/F:

 

Date of Birth:

 

Requested grade:

 

Entry Year:

 

Present grade:

 

Day/ Boarder:

 

Current school (Name, City, State, Country):

 

Parent 1 name:

 

Parent 1 address:

 

Parent 1 telephone number:

Home:

Business:

Cell:

Fax:

 

Parent 1 e-mail:

 

Parent 2 name:

 

Parent 2 address:

 

Parent 2 telephone number:

Home:

Business:

Cell:

Fax:

 

Parent 2 e-mail:

 

Person completing this inquiry:

If other, please specify:

 

How did you hear about Bement?

 

Would you like to receive information about applying financial aid application?

Financial Aid is available to US Citizens only, and is based on demonstrated financial need.

 

If you wish, please add additional comments below:

 

Please remember to click "Submit" when you are ready to send the form.

Thank you for your interest in Bement!


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