Request Informational Materials

Use this form to let Buck's Rock, Llc know that you are interested in learning fully about their school. Provide your information below to request this school's viewbook and application.

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Info Request from: Buck's Rock, Llc Admissions

Guardian Information:

Are you the:                     Parent   Prospective Student

Name of parent / guardian:

Email of guardian:             
                                       (optional if student email inputted above)

Student information:

First name:                        

Middle name:                     

Last name:                        

Email of student or parent:   
                                         (optional if guardian email inputted above)

Student date of birth:          

Country of citizenship:        

Student is:                        Male   Female

Currently in grade:             

Target start date:                 

Name of current school:      

School type:                     

Applying for financial aid?:  Yes  No  Don't Know

About The Student:

The more information schools know, the better they can help you. Please describe academic, athletic, and extracurricular interests of the student. You may also want to mention the type of schools/programs your family is seeking. (Note: 2-4 sentences is recommended)

Home Address and Phone:

Address:                            

City:                                  

State (only if within USA):   

Zip:                                     (enter "n/a" if not applicable)

Country:                            

Phone:                               

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