Request for Information

Thank you for your interest in The Melrose School. When you complete and send this form, we will send you a packet of information about our school, including a viewbook and application. If you have other questions or comments, let us know in the appropriate box below or send them to Tom Burns, Director of Admission via email to: “tburns@melrose.edu”

Parent Information

Mother Title First Name Last Name

Father Title First Name Last Name

Student Information

First Name Last Name Gender Date of Birth (MM/DD/YYYY)

Contact Information

Street Address City State Zip Code

Phone Email Address

Additional

Current Grade Current School Grade Applying For Year Applying For

How did you hear about The Melrose School?

Additional Questions or Comments

Please check if you would like to receive Financial Aid Information Please check if you will be making another admissions inquiry after this submission

The Melrose School

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