Request Information

I love to help families from the community make wise educational choices. In fact, I view this as an integral part of my ministry here. I want to meet with you for an Educational Consultation. During our time together we will talk about your child’s needs, goals and special abilities. We will discover why you are interested in Spencerville Adventist Academy, and ensure that your child will be well served by attending here. At the same time we can answer questions you have about our school. I look forward to meeting with you.

Brian Kittleson

Principal, SAA

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Parent/Guardian Information
Salutation *

First Name *

Last Name *
Email Address *

Gender

Male Female
Cell Phone

(Ex: 999-999-9999)
How Did You Hear About Us?

Details:
Home Phone *

(Ex: 999-999-9999)

What is the purpose of this information inquiry? *

Education Consult

Financial Consult

Application Question

Why are you considering Spencerville Adventist Academy? *

School Culture	Strong Academics	Spiritual Environment
Extracurricular Activities	Facility	Good Teachers
Positive Student Influence	Strong Administration	Well rounded program
Conservative	Location	Other
Good Student/Teacher Ratio

Is your student interested in participating in one of our performance bands? If yes, what instrument does he/she play? *
Does your student enjoy singing or performing? If so, would he or she like to be part of the choir or drama program?

Is your student interested in athletics? If so, which sports would he/she want to participate in?

Soccer	Gymnastics	Volleyball
Golf	Basketball	Baseball
Softball

How did you hear about Spencerville Adventist Academy? *

WGTS radio station	Word of mouth	Community Advertising
Website	Friend	Online search
Teacher	Pastor	Academy Day
Walk in	Neighbor

Student 1
First Name *

Last Name *
Grade Level of Interest *

School Year *
Current School
Is There Another Student? Yes No
Parent/Guardian Notes

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