Editing previous response:

Please fix the highlighted areas below before submitting.

2019 Open House Registration

Please complete the form below.

Sunday, November 17, 2019

9:00am-12:30pm

1600 Queen Anne Road, Teaneck, NJ 07666

Student Information

First Legal Name:*

Answer Required

First Preferred Name:*

Answer Required

Last Name:*

Answer Required

Student E-mail:

Answer Required

Student Cell Phone:

Answer Required

Current middle school:*

Answer Required

Home Address

Address:*

Answer Required

City:*

Answer Required

State:*

Answer Required

Zip:*

Answer Required

Mother

First Name:*

Answer Required

Last Name:*

Answer Required

Address

Please fill out if mother's address is different from student's home address.

Street Address

Answer Required

City

Answer Required

Zip/Postal

Answer Required

Email:*

Answer Required

Home Phone:

Answer Required

Cell Phone:

Answer Required

Father

First Name:*

Answer Required

Last Name:*

Answer Required

Address

Please fill out if father's address is different from student's home address.

Street Address

Answer Required

City

Answer Required

Zip/Postal

Answer Required

Email:*

Answer Required

Home Phone:

Answer Required

Cell Phone:

Answer Required

How did you hear about the open house?

Select all that apply:

Answer Required

Postcard

Website

Newspaper Ad

Friend

Email Blast

Facebook

** Please be mindful to arrange proper childcare for younger siblings. Open House is for prospective students and parents. Thank you for your understanding.