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Winter Visit Day 2021
Monday January 18, arrive at 8:00 a.m. and pick up at 3:15 p.m.
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* Indicates required question
Student's First Name
*
Your answer
Student's Last Name
*
Your answer
Is the student male or female?
*
Female
Male
Current Grade
*
8th
9th
10th
11th
Current School
*
Clear Creek Amana
Heritage Christian School
Hillside Christian School
Home School
Iowa City Community Schools
Lutheran Interparish School
Mid-Prairie Community Schools
WACO
Washington Community Schools
Williamsburg Community Schools
Other:
Parent/Guardian First & Last Name
*
Your answer
Parent/Guardian Email Address
*
Your answer
Parent/Guardian Cell Phone Number
*
Your answer
Parent/Guardian Email Address
*
Your answer
Family's Current Church Name
*
If you are not currently attending a church, please write "none".
Your answer
What are your child's interests?
*
Check all that apply.
Art
Agriculture
Building
Drama
Foreign Language
History
Literature/Reading
Math
Music
Science
Social Studies
Sports
Student Government
Technology
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