Admissions Information Request Form
Thank you for your interest in Wesleyan School. Please complete the form in order to receive information about our application process and upcoming events.



Student Information

*First Name:
Middle Name:
*Last Name:
Suffix:
Preferred Name:
*Gender:
*Date of Birth:   (mm/dd/yyyy) 
*Home Address:
*City:
*State:
*Zip Code:
Country:
Proposed Entry to Wesleyan School
*Grade:
*Year:    

Parent Information
*Relationship to Student:
*Title:
*First Name:
Middle Name:
*Last Name:
Suffix:  
*Primary Contact Number:   (770-555-1234)  
*Phone Type:
*E-mail:
*Conifrm E-mail:

Specific Information Request
What information do you need?
Thank you for requesting information about Wesleyan School. If you have any questions about the admissions process, please feel free to contact our office at 770-448-7640.