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 Middle Name
Student Last Name
*

Usually Called
Gender
Street Address
*

City
*

State/Province
*

Zip Code
*

Country
Student Email
*
We won't ask you to type it twice (we know you hate that), but we do ask that you enter your email address carefully, as it is our primary mode of contact.

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 (Optional)
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. About two weeks prior to Discovery Day, you will receive a confirmation letter; at this point please contact us as instructed if you would like to schedule an interview. First preference is given to those students who have started an application, and those traveling great distances. However, we do our best to make an interview available to all interested visitors.
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I have additional questions. Please have my admission counselor contact me.
Please note questions and comments here: