Skip Navigation

Request Information

Thank you for your interest in Dominican Academy!

Please complete this form to receive information about upcoming events, activities, opportunities for prospective students and their families.

* Indicates a required field.

Parent / Guardian Information
  • First Parent / Guardian
  • First Name *
  • Last Name *
  • Salutation
  • Email Address *
  • Confirm Email Address *
  • Cell Phone
Home Address
  • Street Address
  • City
  • Country
  • State
  • Zip
  •  
  • Student 1
  • First Name *
    Middle Name
    Last Name *
  • Birthdate
    (mm/dd/yyyy)
  • Grade Level of Interest *
    School Year *

  • What grade is your child currently enrolled in?
    *

  • Student's Current School
    *

  • How did you hear about D.A.? 
    *

  • Additional Information (e.g. Where did you meet Admissions Representative, Special Circumstances; any additional information you would like Admissions to be aware of?) 
  •  
  • Is There Another Student?
    Yes No
  •