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Request Information

Thank you for your interest in Premier Academy!

Please fill out the form below and our Admissions Office will contact you.

* Indicates a required field.

Parent / Guardian Information
  • First Parent / Guardian
  • First Name *
  • Last Name *
  • Email Address *
  • Confirm Email Address *
  • Cell Phone
  • Second Parent / Guardian
    (leave blank if not applicable)
  • First Name *
  • Last Name *
  • Email Address *
  • Confirm Email Address *
  • Cell Phone
  • How Did You Hear About Us?
    Details:

  • Would you like to attend an in person Open House, which will include a tour of campus?
    Yes   No

  • If you are applying for your child for Kindergarten, would you like to register for Kindergarten Preview Night?
    Yes   No

  • Are you ready  to apply?
    Yes   No
  •  
  • Student 1
  • First Name *
    Last Name *
  • Birthdate
    (mm/dd/yyyy)
    Gender
  • Grade Level of Interest *
    School Year *
  • Student Interests
    Clubs
    Fine Arts
    Sports
  • Current School
    Other:
  •  
  • Is There Another Student?
    Yes No
  •  
  • Parent / Guardian Notes
  •