New Roads School
Thank you for your interest in New Roads School!


Please note: This form is not an application. To apply to New Roads, please visit our website at www.newroads.org

Applicant Information
Prospective Student 1 First Name *
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Prospective Student 1 Last Name *
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Preferred Name
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Date of Birth *
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Prospective Student 2 First Name
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Prospective Student 2 Last Name
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Date of Birth
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Entering Year *
Entering Grade(s): *
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Current School(s) *
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Family Information:
Parent/Guardian 1 First Name: *
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Parent/Guardian 1 Last Name: *
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Parent/Guardian 2 First Name:
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Parent/Guardian 2 Last Name:
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Address line 1 *
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Address line 2
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City *
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Zip code *
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Who lives at this address? *
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Email 1: *
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Email 2:
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Phone Number *
Best number to reach you
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How did you hear about New Roads? *
Area(s) of Interest *
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Additional Information, Questions or Comments?
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