Montclair Kimberley Academy

Thank you for your interest in The Montclair Kimberley Academy! If you fill out the information below and click the Submit button, the Admissions Office will send you an application packet. Please note that an asterisk denotes a required field. If you have questions, please type them in the box provided, and an admissions officer will contact you.

*Student First Name:
*Student Last Name:
Student email:
*Student Sex:	Please choose F M
*Student Date of Birth:	Month / Day / Year
Reference Source:	Please choose Alumnus Referral Coach Current Family/Parent Current Student Educational Consultant MKA Admission Event Faculty/Staff Friend (Non-alumnus) Internet Newspaper/Magazine Reputation/Word of mouth School Fair School referral Website/Directory - Boarding School Review Website/Directory - Bunting and Lyon Website/Directory - ISEE Website/Directory - NAIS Website/Directory - Peterson's Website/Directory - Porter Sergeant Website/Directory - SSAT Website/Directory - NJAIS Website/Directory - Vincent Curtis Other
*Current Grade:	Please choose Nursery Pre-K K 1 2 3 4 5 6 7 8 9 10 11 12
*Entry Grade:	Please choose Pre-K K 1 2 3 4 5 6 7 8 9 10 11 12
*Desired Year of Entry:
	Financial Aid Requested
	Sibling is Also Inquiring or Applying to School
Home Address:
*Street:
*City:
*State:
*ZIP/Postcode:
Country:
*Home Phone:
First Parent's Relation to Student:	Please choose Father Mother Guardian Other
*First Parent's Prefix (Mr, Ms, Mrs, etc):
*First Parent's First Name:
*First Parent's Last Name:
First Parent's Suffix (Jr, III, etc):
First Parent's Work Phone:
*First Parent's Email:
Second Parent's Relation to Student:	Please choose Father Mother Guardian Other
Second Parent's Prefix (Mr, Ms, Mrs, etc):
Second Parent's First Name:
Second Parent's Last Name:
Second Parent's Suffix (Jr, III, etc):
*Specific Areas of Interest: Ctrl-Click for multiple selections (Cmd-Click on the Mac). Select as many as desired.	Art Baseball Basketball Cheerleading Chess Dance Drama Fencing Field Hockey Football Golf Ice Hockey Lacrosse Music-choral Music-instr. Soccer Softball Swimming Track Track-x country Tennis Volleyball Wrestling
Additional Comments or Questions:
*Have you seen any of MKA's advertisements?	Yes No
If yes, which magazine or newspaper?
What school does your child currently attend?