Pennsylvania International Academy

Request Informational Materials

Let us know that you are interested in learning about our program. Provide your information below to request additional informational materials. Your request will typically be processed within 24 hours.

Are You The:	Parent / Guardian Prospective Student
Parent / Guardian Information
Name of Parent / Guardian:
E-mail of Parent / Guardian:	(Optional if student's e-mail address is provided below.)
Student Information
First Name:
Middle Name:
Last Name:
E-mail of Student:	(Optional if guardian's e-mail address is provided above.)
Date of Birth:
Country of Citizenship:
Gender:	Male Female
Current Grade:
Seeking Admission For Grade:
Target Start Date:
Name of Current School:
School Type:
Applying for Financial Aid?	Yes No I Don't Know
About the Student: The more information schools know, the better we can help you. Please describe academic, athletic, and extracurricular interests of the student. You may also want to mention the type of school/programs your family is seeking. (Note: 2-4 sentences is suggested)
Home Address and Phone Number
Address:
City:
Country:
State / Province:
Zip / Postal Code:	(Please enter "n/a" if not applicable)
Phone Number: