Upland Country Day School - A Lifetime Of Learning Begins At Upland.

Upland Country Day School Admissions Office

Request for Information

Please send an Information Packet to:

Student's First Name:
Last Name:
	Male Female

Student's Date of Birth:

Home Address:
City:
State:
Zip:

Home Phone:
E-mail:
Fax:
Father/Guardian's Name:
Mother/Guardian's Name:

Applying for Grade:

Beginning in September	(Year)
Student's current school:
Would you like to receive financial aid information?	Yes

How did you hear about Upland?
	Other (Explain):