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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
I am a...
I am a...
Prospective Student
Parent/Guardian
School Counselor
Community Based Organization
Consultant
Please
click here
to provide more information about yourself and to be added to our email list.
What CBO is this student working with?
Consultant First Name
Consultant Last Name
Relationship Type
Educational Consultant
Consultant Email
Student Demographic Information
Student's Legal First Name
Middle Name
Last Name
Suffix
Jr.
Sr.
I
II
III
IV
V
Student's Chosen Name
Date of Birth
Date of Birth
January
February
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1905
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1903
1902
1901
1900
Gender
Female
Male
Self-Identify
Additional gender information
Pronouns
He/Him/His
She/Her/Hers
They/Them/Theirs
Mailing Address
Mailing Address
Country
Street
City
Region
Postal Code
Primary Email Address
Please verify the accuracy of this email address and make sure it is checked regularly.
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
If your school
does not appear,
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to provide additional information so we can add it to our database.
Mailing Address
Mailing Address
Country
Street
City
Region
Postal Code
Current Grade
3
4
5
6
7
8
9
10
11
12
Enrollment Information
School Year Applying For
2025-26
2026-27
2027-28
2028-29
2029-30
2030-31
CBO Year
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
Preferred Name
Email
Relationship to Student
Father
Mother
Step-Father
Step-Mother
Legal Guardian
If this parent attended Loomis Chaffee, enter the class year.
School Name
Parent/Guardian 2
First Name
Last Name
Preferred Name
Email
Relationship to Student
Father
Mother
Step-Father
Step-Mother
Legal Guardian
If this parent attended Loomis Chaffee, enter the class year.
School Name
Do you have any other family connections to Loomis Chaffee?
Do you have any other family connections to Loomis Chaffee?
Yes
No
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Family Connection
_ID_
First Name
Last Name
Relationship to Student
Father
Mother
Step-Father
Step-Mother
Legal Guardian
Brother
Sister
Grandfather
Grandmother
Great-Grandfather
Great-Grandmother
Aunt
Uncle
Cousin
Grandchild
Other
Explain the connection.
LC Class Year
School Name
Additional Connection
Student Interests
Add interests from the categories below. Provide additional information if desired so we can better tailor the admission process just for you!
Delete
Interest
_ID_
Type
Academic
Dance
Music
Student Activities
Theater
Visual Arts
Academic Interest
Computer Science, Design Thinking, Entrepreneurship
Economics, Government, Psychology
English
History, Philosophy, Religious Studies
Mathematics
Modern and Classical Languages
Science
Student Activities
Civic Engagement
Community Service
Debate
Diversity and Inclusion
Environmental Studies
Global Studies
LGBTQ
Model UN
Robotics
Student Government
Writing
Other Student Activities
Dance Interest
Ballet
Choreography
Contemporary Dance
Hiphop
Jazz Dance
Modern Dance
Other Dance
Music Interest
Bagpipes
Band
Bassoon
Cello
Chamber Music
Choir
Choral Ensemble
Clarinet
Double Bass
Drum Set
Electric Bass
Euphonium
Flute
French Horn
Guitar
Harp
Harpsichord
Jazz Band
Oboe
Orchestra
Organ
Percussion
Piano
Piccolo
Saxophone
Trombone
Trumpet
Tuba
Viola
Violin
Voice
Other Music
Theater Interest
Acting
Directing
Improvisation
Play writing
Public Speaking
Technical Theater
Theatrical Production
Other Theater
Visual Arts Interest
Ceramics
Computer Graphics
Digital Animation
Drawing
Film and Video Production
Illustration
Painting
Photography
Pottery
Print Making
Sculpture
Videography
Water Color
Woodworking
Other Visual Arts
Please tell us more about your interest and experience.
Provide up to 3 web-based links to public videos and/or portfolios. Please do not submit links to iCloud or Google Drives.
Add Academic & Co-Curricular Interest
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Athletic Interest
_ID_
Sport
Coed Equestrian
Boys Cross Country
Boys Soccer
Boys Water Polo
Field Hockey
Football
Girls Cross Country
Girls Soccer
Girls Volleyball
Baseball
Boys Golf
Boys Lacrosse
Boys Tennis
Boys Track and Field
Girls Golf
Girls Lacrosse
Girls Tennis
Girls Track and Field
Girls Water Polo
Softball
Boys Basketball
Boys Hockey
Boys Squash
Boys Swimming and Diving
Coed Skiing
Girls Basketball
Girls Hockey
Girls Squash
Girls Swimming and Diving
Position(s) if applicable
In the space provided, please tell us about your current school and/or club team(s) and your experiences with each. Share your accomplishments, awards, and statistics in this sport.
School Coach's Name
School Coach's Email
Club Coach's Name
Club Coach's Email
Provide up to 3 web-based links to public highlight videos. Please do not submit links to iCloud or Google Drives.
Add Athletic Interest
Additional Information
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