Name & Relationship:

Your Name (Last, First):

Relationship to student:

Student's Name:

Student's Age:

Student's Current Grade:

Contact Information:

E-mail address:

Street Address:

Address (cont'd):

City:

State / Province:

Zip / Postal Code:

Country:

Home Phone Number:

Work Phone Number:

Cell Phone Number:

Best time to reach you by phone?

Enrollment Information:

The student would enroll in grade:

Month / Year of Student Enrollment:

Are you interested in summer school?

Activities & Athletics Information:

Which athletic team(s) is the student interested in?

Which activity(ies) is the student interested in?

Discovery Method Survey:

How did you first find out about Hargrave?
Select One Hargrave Graduate Current Cadet Friend Google Yahoo AOL.com MSN.com bing.com Facebook.com mysummercamps.com boardingschoolreview.com campchannel.com School Fair Sporting Event Hargrave Employee Newspaper Virginia Living Boys Life Other Magazine Television Coach UNSA Foundation Counselor Not Listed

How did you find HMA's web site address?
Select One AOL Search Altavista Excite Hotbot In a print ad Infospace Google Lycos Northern Light Peterson's Guide Webcrawler Yahoo Other>>

Other method -please be specific:

Did Hargrave alumni mention the Academy? What is his/her name?

Information

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Comments or Questions:

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