The Independence School

About the Student

If you have an interest in inquiring for a 2nd child, please see the option at the bottom of the form to submit another Inquiry that will auto fill.

Name

First

Middle

Last

Suffix

Preferred Name

Gender

Date of Birth

mm/dd/yyyy

Current Grade

ECI (Early Childhood I) 3 years old by Sept. 15th and toilet trained

ECII (Early Childhood II) 4 years old by Sept. 15th and toilet trained

Interested in Grade

For the Fall of

Current School

About the Parent/Guardian

Name

Title

First

Middle

Last

Suffix

Preferred Name

Relationship to Student

Primary Phone (xxx-xxx-xxxx)

Type

Number

Secondary Phone (xxx-xxx-xxxx)

Type

Number

Email

Mailing Address

How can we help you today?

I would like to:

Join us at our In Person Open House!

Please select an In Person Open House time:

Contact for this appointment

First Name

Last Name

Phone

Email

Experience The Independence School

Please select a Tour time:

Contact for this appointment

First Name

Last Name

Phone

Email

Tell us more:

What questions can we answer?

How would you like us to reach out?

Thanks for reaching out! Out of curiosity...

How did you hear about The Independence School?

Who can we thank?

Please specify

Name of Event

Parent Graduation Year

Parent Maiden Name (if applicable)

I would like to receive Indy Insights, The Independence School's blog

Yes No

If you have another child or grade of interest please click submit and start another and your data will pre-fill accordingly.