La Sierra Academy

Elementary Information Request Form

4900 Golden Avenue, Riverside, CA 92505 - Phone 951-351-1445; Fax 951-689-3708

Fill out this form to receive an information packet and enrollment information.

*Student Name:
*Parent/Guardian(s) Name:
*City: *State: *Zip:
*Phone Number:
School Student Currently Attends:
E-mail Address:

How did you hear about La Sierra Academy - Elementary?

(Check all that apply)

Friend   Newspaper Ad   Radio Announcement   Internet    Local Resident

Other (Specify)

Tell us how can we be of service to you right now!

Send Information Packet   Arrange for a Campus Tour   Preview a School Video

Choose Grade(s):   K    1st    2nd    3rd   4th   5th   6th

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