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Request Information

Thank you for your interest in Chesterton Academy of St Mary's, a high school with a higher purpose!

Please fill out the form below, and our Admissions Office will contact you shortly to provide additional information regarding your request. If you'd like to schedule a Shadow Day, please provide us with your first, second, and third choice for possible dates below. Leave any additional comments in the "Parent Notes" below.

Pax et bonum,

* Indicates a required field.

Parent / Guardian Information
  • First Parent / Guardian
  • First Name *
  • Last Name *
  • Salutation *
  • Email Address *
  • Confirm Email Address *
  • Cell Phone *
Home Address
  • Street Address *
  • City *
  • Country *
  • State
    *
  • Zip
    *
  • Home Phone
  • How Did You Hear About Us? *
    Details:

  • If you'd like to schedule a Shadow Day, please provide your first choice below:
    (mm/dd/yyyy)

  • Please provide your second choice below:
    (mm/dd/yyyy)

  • Please provide your third choice below:
    (mm/dd/yyyy)
  •  
  • Student 1
  • First Name *
    Middle Name
    Last Name *
  • Birthdate *
    (mm/dd/yyyy)
    Gender *
  • Grade Level of Interest *
    School Year *
  • Current School
  •  
  • Is There Another Student?
    Yes No
  •  
  • Parent / Guardian Notes
  •