Your name: [required field] Current Grade: 11 10 9 8 7 6 5 4 3 2 1 K PK Grade Applying For: 12 11 10 9 8 7 6 5 4 3 2 1 Desired Entry Date: Fall Winter 2004 2005 Students Gender: Male Female Students Age: Person completing this form: Student Parent Grandparent Counselor Teacher Administrator Consultant Priest/Minister Other Student's name: Parent's name: Mr. Mrs. Ms. Mr. & Mrs. Dr. Home Address: (location where you wantadmissions information sent) City: State/Province: Zip/Postal Code: Country: Home Phone: (include country/area code) Work Phone: (include country/area code) Email Address: [required field] School Now Attending: First preferencein location fora boarding school: No Preference Arkansas Illinois Indiana Iowa Kansas Michigan Minnesota Missouri Ohio Wisconsin First preferencein type of boarding school: None/Don't know All-Boys All-Girls Co-Ed Military How did you discover this website? Internet search Boarding school directory Friend, family member A school A link from another site Questions or comments? Do you wish to have financial aid information included in any materials sent to you? Yes: No: Click here to submit your request For a print version of the Midwest Boarding Schools directory call (800) 799-6927 Thank you for your interest in Midwest Boarding Schools!