Request Information

Hello, and thank you for your interest in Lipscomb Academy!

Please fill out the form below and our Admissions Office will follow up regarding your inquiry.

Note: To be considered for admissions, PK and PK-3 day applicants must turn 4 by August 30 of the enrollment year, and Kindergarten applicants must turn 5 by August 30 of the enrollment year.

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Parent/Guardian Information
*First Parent/Guardian
Salutation

First Name *

Middle Name

Last Name *
Email Address *

Gender

Male Female
Second Parent/Guardian
Salutation

First Name

Middle Name

Last Name
Email Address

Gender

Male Female
How Did You Hear About Us? *

Details:
Home Phone *

(Ex: 999-999-9999)
Street Address *
City *
Country *
State *
Zip *
Student 1
First Name *

Middle Name

Last Name *
Birthdate

(mm/dd/yyyy)

Email Address

Gender

Male Female
Grade Level of Interest *

School Year *
Student Interests

Athletics

Baseball Basketball Bowling Cheerleading Cross Country Football Golf Soccer Softball Swimming Tennis Track Volleyball Wrestling

Fine Arts

Art Band Chorus Drama

Misc

Broadcasting Communications/PR Computer/Programming Gaming Horseback Riding
Current School
Is There Another Student? Yes No