Request Information

We would be thrilled to send you more information.

Please use this short form to make your request. We will get back to you right away.

Student First Name*

Answer required for "Student First Name"

Student Last Name*

Answer required for "Student Last Name"

Parent or Guardian First Name*

Answer required for "Parent or Guardian First Name"

Parent or Guardian Last Name*

Answer required for "Parent or Guardian Last Name"

Phone*

Number Required

Email*

Answer required for "Email"

Permanent Residence (USA - City & State OR International - City & Country)*

Answer required for "Permanent Residence (USA - City & State OR International - City & Country)"

Planning to live in the dormitory?*

Answer required for "Planning to live in the dormitory?"

Yes

Gender*

Answer required for "Gender"

Male

Female

Grade Entering*

Answer required for "Grade Entering"

Are you a member of the SDA church?*

Answer required for "Are you a member of the SDA church?"

Yes

Please let us know any questions or concerns you may have.

Answer required for "Please let us know any questions or concerns you may have."

783 San Andreas Road

La Selva Beach, CA 95076

Please fix the highlighted areas below before submitting.