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Loomis Chaffee Inquiry Form
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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
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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.
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I
II
III
IV
V
Student Preferred Name
Date of Birth
Date of Birth
January
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1
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1900
Gender
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Additional gender information
Mailing Address
Mailing Address
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Street
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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
2021-22
2022-23
2023-24
2024-25
2025-26
2026-27
2027-28
2028-29
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
Legal Guardian
Step-Father
Step-Mother
Brother
Sister
Grandfather
Grandmother
Educational Consultant
Sending Program
Student
Aunt
Uncle
Cousin
Grandchild
Great-Grandfather
Great-Grandmother
Parent/Guardian 2
First Name
Last Name
Email
Relationship to Student
Father
Mother
Legal Guardian
Step-Father
Step-Mother
Brother
Sister
Grandfather
Grandmother
Educational Consultant
Sending Program
Student
Aunt
Uncle
Cousin
Grandchild
Great-Grandfather
Great-Grandmother
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
Dance
Music
Theater
Visual Arts
Civic Engagement
Community Service
Debate
Diversity and Inclusion
Environmental Studies
Global Studies
Innovation Center
LGBTQ
Model UN
Robotics
Student Government
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
Wrestling
Additional Information
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