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Information Request Form

Please complete this form to obtain additional information about Buxton School.
(* required fields)
STUDENT INFORMATION:

 
*First Name: * Last Name:
*Date of Birth:
Mo.
Day
Yr.

  
*Gender: Male Female

U.S. Citizen:
Yes No

*Current School:


Public Private

*Current Grade:


*Interested in Grade:
 9 10 11

Student type: Boarding Day Financial Aid:

*School Year Here:

SEND INFORMATION TO:

Student Parent Other
Name (if different from above):
First
 Last
*Mailing Address:

            

*City:  
State/Province:
Zip Code: Country:
*Telephone: Email:
 

How did you hear about Buxton?



 

Please list your interests:

Academic:

Sports:

Visual/Performing Arts:

Other:

 Additional interests and comments:

If you have questions, please feel free to call Annie Dutka '03 in the Admissions Office
at 413-458-3919 x108.

Before you submit, would you please complete our short site survey below?

1. Did you find the information you were looking for? Yes No

If yes, what was that information?
If no, what should we add to the site?

2. What did you like best about our site?

3. What did you like least about our site?

4. What was your overall impression?


Please click "submit" when you have completed this form.