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STUDENT INFORMATION
Student First Name *
Student Last Name *
Student Preferred Name *
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Date of Birth *
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Current Grade Level *
Entering Grade Level *
Year of Entry *
Current School Name *
Current School Location (city, state) *
Academic Interests 1 *
Academic Interests 2
Extracurricular Interests 1 *
Extracurricular Interests 2
Extracurricular Interests 3
Please tell us more about your child, so that we can better serve your family in the admission process.
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PARENT/GUARDIAN 1 INFORMATION
Relation to Student *
Parent/Guardian 1 Title (Mr. / Mrs.) *
Parent/Guardian 1 First Name *
Parent/Guardian 1 Last Name *
Parent/Guardian 1 Email *
Parent/Guardian 1 Mobile Phone *
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HOUSEHOLD INFORMATION
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ADDITIONAL INFORMATION
If any relative has attended Reverend Brown, please list his/her name, relation to applicant, and years attended.
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