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Thank you for your interest in Salem Baptist Christian School!

Please complete the form below to be contacted by our admissions office.

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Parent / Guardian Information
  • First Parent / Guardian
  • First Name *
  • Last Name *
  • Salutation *
  • Email Address *
  • Gender *
  • Cell Phone *
    (Ex: 999-999-9999)
  • Second Parent / Guardian
    (leave blank if not applicable)
  • First Name *
  • Last Name *
  • Salutation *
  • Email Address *
  • Gender *
  • Cell Phone *
    (Ex: 999-999-9999)
Home Address
  • Street Address *
  • City *
  • Country *
  • State
    *
  • Zip
    *
  • Home Phone *
    (Ex: 999-999-9999)
  • How Did You Hear About Us? *
    Details:
  • Does student have an alumni parent?

    * Yes   No
  • What is the alumni name and graduating year?

  • Discovery Day

  •  
  • Student 1
  • First Name *
    Last Name *
  • Gender *
  • Grade Level of Interest *
    School Year *
  •  
  • Is There Another Student?
    Yes No
  •  
  • Parent / Guardian Notes
  •