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Loomis Chaffee Inquiry Form_OLD
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Thank you for your interest in Loomis Chaffee. Please take a moment to tell us more about yourself by filling out the inquiry below. Required information is marked with an asterisk (*).
About You
I am a...
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Prospective Student
Parent/Guardian
School Counselor
Community Based Organization
Consultant
Student Demographic Information
Student First Name
Middle Name
Last Name
Suffix
Jr.
Sr.
I
II
III
IV
V
Student Preferred Name
Date of Birth
Date of Birth
January
February
March
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December
1
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31
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1910
1909
1908
1907
1906
1905
1904
1903
1902
1901
1900
Gender
Female
Male
Self-Identify
Additional gender information
Mailing Address
Mailing Address
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Street
City
Region
Postal Code
Primary Email Address
Please verify the accuracy of this email address and make sure it is checked regularly. All communications will be sent to this email.
Are you Hispanic/Latino?
Are you Hispanic/Latino?
Yes
No
Race (select all that apply)
Race (select all that apply)
Asian American
Black/African American
Middle Eastern American
Native American
Pacific Islander American
White/European American
Prefer not to answer
Current School Information
School Name
CEEB Code
Mailing Address
Mailing Address
Country
Street
City
Region
Postal Code
Current Grade
3
4
5
6
7
8
9
10
11
12
Enrollment Information
Year Applying For
2025-26
2026-27
2027-28
2028-29
2029-30
2030-31
Boarding or Day
Boarding or Day
Boarding
Day
Undecided
Grade Applying For
9
10
11
12
Post-Graduate
Are you interested in financial aid?
Are you interested in financial aid?
Yes
No
Undecided
Have you previously applied to Loomis Chaffee?
Yes
No
Primary Parent/Guardian Information
Parent/Guardian 1
First Name
Last Name
Email
Relationship to Student
Father
Mother
Step-Father
Step-Mother
Legal Guardian
Brother
Sister
Grandfather
Grandmother
Great-Grandfather
Great-Grandmother
Aunt
Uncle
Cousin
Grandchild
Educational Consultant
Sending Program
Student
Parent
Child
Other
Parent/Guardian 2
First Name
Last Name
Email
Relationship to Student
Father
Mother
Step-Father
Step-Mother
Legal Guardian
Brother
Sister
Grandfather
Grandmother
Great-Grandfather
Great-Grandmother
Aunt
Uncle
Cousin
Grandchild
Educational Consultant
Sending Program
Student
Parent
Child
Other
Student Interests
Select up to 3 from each set below.
Academic Department
Academic Department
Economics, Government, Psychology
English
History, Philosophy, Religious Studies
Mathematics
Modern and Classical Languages
Science
Co-Curricular
Co-Curricular
Civic Engagement
Community Service
Computer Science, Design Thinking, Entrepreneurship
Dance
Debate
Diversity and Inclusion
Economics, Government, Psychology
English
Environmental Studies
Global Studies
History, Philosophy, Religious Studies
LGBTQ
Mathematics
Model UN
Modern and Classical Languages
Music
Robotics
Science
Student Government
Theater
Visual Arts
Writing
Athletics
Athletics
Baseball
Boys Basketball
Boys Cross Country
Boys Golf
Boys Hockey
Boys Lacrosse
Boys Soccer
Boys Squash
Boys Swimming and Diving
Boys Tennis
Boys Track and Field
Boys Water Polo
Coed Equestrian
Coed Skiing
Field Hockey
Football
Girls Basketball
Girls Cross Country
Girls Golf
Girls Hockey
Girls Lacrosse
Girls Soccer
Girls Squash
Girls Swimming and Diving
Girls Tennis
Girls Track and Field
Girls Volleyball
Girls Water Polo
Softball
Additional Information
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