Inquiry Form

Thank you for your interest in Lehrman Community Day School!

Please note that for the 2021-2022 school year we have received a record number of new applications and we have completed the first admission review. Applications submitted at this point will be reviewed and considered on a rolling basis, based on availability.

Please complete the information in this form to join one of our virtual Early Childhood Open House events.

Someone from the admissions office will reach out to families with children in elementary school (K-5).

* Indicates a required field.

Parent / Guardian Information
First Parent / Guardian Last Name * First Name * Middle Name Salutation Email Address * Gender Male Female Work Phone (Ex: 999-999-9999) Cell Phone (Ex: 999-999-9999)	Second Parent / Guardian (leave blank if not applicable) Last Name * First Name * Middle Name Salutation Email Address * Gender Male Female Work Phone (Ex: 999-999-9999) Cell Phone (Ex: 999-999-9999)

Home Address
Street Address * City * Country * State * Zip * Home Phone * (Ex: 999-999-9999) How Did You Hear About Us? * Details: Student's current grade level * Student 1 First Name * Middle Name Last Name * Birthdate * (mm/dd/yyyy) Gender * Male Female Grade Level of Interest * School Year * Current School Is There Another Student? Yes No Parent / Guardian Notes