Reservation for Discovery Day

Thank you for your interest in Simon's Rock. Please use the form below to register for a Discovery Day

Your Information   ( * = required field)
Student First Name
 *
Student Last Name
 *
Gender
Street Address
*
City
*
State/Province
 *
Zip Code
 *
Country
Student Email
 *
Phone
 
 Date of Birth:
Month
Day
Year
High School
 *
High School City/Town
High School State/Province
High School Country
Anticipated Year of Graduation
 *
Academic Interests
Extra Curricular Interests
Ethnic Background
Please check all that apply
 African American, Black
American Indian, Alaska Native
        tribal affiliation:   enrolled:
Asian American
        country/ies of family's origin:
Asian, including the Indian Subcontinent
        country/ies:
Hispanic, Latino/Latina
        country/ies:
Mexican American, Chicano/Chicana
Native Hawaiian, Pacific Islander
Puerto Rican
Unknown
White, Caucasian
Other       specify:
How did you hear about Simon's Rock?
Upcoming Discovery Days
 Please select the Discovery Day you wish to attend. Confirmation letters are sent approximately three weeks prior to the event. We will contact you by phone if space is no longer available and rescheduling is necessary.
Interview request
 Admission interviews are a required part of the application and are available on Discovery Days. First preference is given to those students who have started an applicaion, and those traveling great distances. However, we do our best to make an interview available to all interested visitors.
Yes, I would like an interview
No, I do not want an interview at this time
YES, put me on your mailing list.
I have additional questions. Please have my admission counselor contact me.
Please note questions and comments here: