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Thank you for your interest in Darlington School. When you complete this form, we will send you a packet of information about our school, including an application for admission. If you have other questions or comments, let us know in the appropriate box below or send them via e-mail to admission@darlingtonschool.org.

Please be sure to complete all the fields bolded in red before submitting the form.

Before you start, please tell us your relationship to the student? I am the Student Parent Grandparent Sibling Other Relative Friend Consultant Other
Primary Contact Information
Title Mr. Mrs. Ms. Dr.	First name
Relationship to Student Aunt Brother Cousin Father Godfather Godmother Grandfather Grandmother Great-Aunt Great-Uncle Great-Grandfather Great-Grandmother Guardian Mother Sister Stepbrother Stepfather Stepgrandfather Stepgrandmother Stepmother Stepsister Uncle	Middle name
	Last name
Spouse Title Mr. Mrs. Ms. Dr.	Spouse First Name
Spouse Relationship to Student Aunt Brother Cousin Father Godfather Godmother Grandfather Grandmother Great-Aunt Great-Uncle Great-Grandfather Great-Grandmother Guardian Mother Sister Stepbrother Stepfather Stepgrandfather Stepgrandmother Stepmother Stepsister Uncle	Spouse Middle Name
	Spouse Last Name
Street Address
City	State Zip
Country UNITED STATES AFGHANISTAN ÅLAND ISLANDS ALBANIA ALGERIA AMERICAN SAMOA ANDORRA ANGOLA ANGUILLA ANTARCTICA ANTIGUA AND BARBUDA ARGENTINA ARMENIA ARUBA AUSTRALIA AUSTRIA AZERBAIJAN BAHAMAS BAHRAIN BANGLADESH BARBADOS BELARUS BELGIUM BELIZE BENIN BERMUDA BHUTAN BOLIVIA BOSNIA AND HERZEGOVINA BOTSWANA BOUVET ISLAND BRAZIL BRITISH INDIAN OCEAN TERRITORY BRUNEI DARUSSALAM BULGARIA BURKINA FASO BURUNDI CAMBODIA CAMEROON CANADA CAPE VERDE CAYMAN ISLANDS CENTRAL AFRICAN REPUBLIC CHAD CHILE CHINA CHRISTMAS ISLAND COCOS (KEELING) ISLANDS COLOMBIA COMOROS CONGO CONGO, THE DEMOCRATIC REPUBLIC OF THE COOK ISLANDS COSTA RICA COTE D'IVOIRE CROATIA CUBA CYPRUS CZECH REPUBLIC DENMARK DJIBOUTI DOMINICA DOMINICAN REPUBLIC ECUADOR EGYPT EL SALVADOR EQUATORIAL GUINEA ERITREA ESTONIA ETHIOPIA FALKLAND ISLANDS (MALVINAS) FAROE ISLANDS FIJI FINLAND FRANCE FRENCH GUIANA FRENCH POLYNESIA FRENCH SOUTHERN TERRITORIES GABON GAMBIA GEORGIA GERMANY GHANA GIBRALTAR GREECE GREENLAND GRENADA GUADELOUPE GUAM GUATEMALA GUINEA GUINEA-BISSAU GUYANA HAITI HEARD ISLAND AND MCDONALD ISLANDS HOLY SEE (VATICAN CITY STATE) HONDURAS HONG KONG HUNGARY ICELAND INDIA INDONESIA IRAN, ISLAMIC REPUBLIC OF IRAQ IRELAND ISRAEL ITALY JAMAICA JAPAN JORDAN KAZAKHSTAN KENYA KIRIBATI KOREA KOREA, DEMOCRATIC PEOPLE'S REPUBLIC OF KOREA, REPUBLIC OF KUWAIT KYRGYZSTAN LAO PEOPLE'S DEMOCRATIC REPUBLIC LATVIA LEBANON LESOTHO LIBERIA LIBYAN ARAB JAMAHIRIYA LIECHTENSTEIN LITHUANIA LUXEMBOURG MACAO MACEDONIA, THE FORMER YUGOSLAV REPUBLIC OF MADAGASCAR MALAWI MALAYSIA MALDIVES MALI MALTA MARSHALL ISLANDS MARTINIQUE MAURITANIA MAURITIUS MAYOTTE MEXICO MICRONESIA, FEDERATED STATES OF MOLDOVA, REPUBLIC OF MONACO MONGOLIA MONTENEGRO MONTSERRAT MOROCCO MOZAMBIQUE MYANMAR NAMIBIA NAURU NEPAL NETHERLANDS NETHERLANDS ANTILLES NEW CALEDONIA NEW ZEALAND NICARAGUA NIGER NIGERIA NIUE NORFOLK ISLAND NORTHERN MARIANA ISLANDS NORWAY OMAN PAKISTAN PALAU PALESTINIAN TERRITORY, OCCUPIED PANAMA PAPUA NEW GUINEA PARAGUAY PERU PHILIPPINES PITCAIRN POLAND PORTUGAL PUERTO RICO QATAR REUNION ROMANIA RUSSIAN FEDERATION RWANDA SAINT HELENA SAINT KITTS AND NEVIS SAINT LUCIA SAINT PIERRE AND MIQUELON SAINT VINCENT AND THE GRENADINES SAMOA SAN MARINO SAO TOME AND PRINCIPE SAUDI ARABIA SENEGAL SERBIA SEYCHELLES SIERRA LEONE SINGAPORE SLOVAKIA SLOVENIA SOLOMON ISLANDS SOMALIA SOUTH AFRICA SOUTH GEORGIA AND THE SOUTH SANDWICH ISLANDS SPAIN SRI LANKA SUDAN SURINAME SVALBARD AND JAN MAYEN SWAZILAND SWEDEN SWITZERLAND SYRIAN ARAB REPUBLIC TAIWAN TAJIKISTAN TANZANIA, UNITED REPUBLIC OF THAILAND TIMOR-LESTE TOGO TOKELAU TONGA TRINIDAD AND TOBAGO TUNISIA TURKEY TURKMENISTAN TURKS AND CAICOS ISLANDS TUVALU UGANDA UKRAINE UNITED ARAB EMIRATES UNITED KINGDOM UNITED STATES MINOR OUTLYING ISLANDS URUGUAY UZBEKISTAN VANUATU VENEZUELA VIET NAM VIRGIN ISLANDS, BRITISH VIRGIN ISLANDS, U.S. WALLIS AND FUTUNA WESTERN SAHARA YEMEN ZAMBIA ZIMBABWE
Phone Home Business Mobile	Primary Contact E-mail
	Confirm E-mail
Student Information
Gender Female Male	Student's first name
Student's Birthdate 1 2 3 4 5 6 7 8 9 10 11 12 / 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 / 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008	Student's middle name
Is the student a U.S. citizen? Yes, a U.S. citizen No, not a U.S. citizen	Student's last name
Current School/Grade   PK K 1st 2nd 3rd 4th 5th 6th 7th 8th 9th 10th 11th 12th PG	Student E-mail
Interested in which year and grade? 2008-20092009-20102010-20112011-20122012-20132013-2014 9th 10th 11th 12th PG
Level of Interest in Boarding Schools Not Interested Just Looking Seriously Considering Will Definitely Attend
How did you hear about Darlington? Admission Representative: Personal visit Admission Representative: School fair Attended Campus Event: Art Attended Campus Event: Darlington Summer Camps Attended Campus Event: Sports Live in area Parent Referral Personal Mailing: General Information Personal Mailing: Soccer Academy Personal Mailing: Tennis Academy Print Advertisement: Air Tran Print Advertisement: Atlanta Business Chronicles Print Advertisement: Atlanta Life Magazine Print Advertisement: Atlanta Magazine Print Advertisement: Atlanta Parents Camp Guide Print Advertisement: Bicycling Print Advertisement: Charlotte Business Journal Print Advertisement: Daily Report Print Advertisement: Daily Tribune Print Advertisement: Directions Print Advertisement: Floyd-Polk-Chattooga-Medical Alliance Print Advertisement: Gordon County Chamber Guide Print Advertisement: Know Atlanta Relocation Guide Print Advertisement: Living Here Magazine Print Advertisement: Montgomery Living Print Advertisement: News Week Georgia Print Advertisement: News Week North Carolina Print Advertisement: Paragon Print Advertisement: Peterson's Guide Print Advertisement: Polk County Chamber Publication Print Advertisement: Right Here in Gordon County Print Advertisement: Rome News Tribune - Young Romans Print Advertisement: Rome Symphony Orchestra Program Print Advertisement: Yellow Pages Referral: Medical Referral: Realtor Referral: Aramco Referral: Darlington alumnus Referral: Darlington Faculty Member Referral: Darlington Legacy Family Referral: Darlington Parent Referral: Darlington Student Referral: Educational Consultant Referral: Former Darlington faculty Referral: Friend/Peer Referral: School Counselor Referral: Soccer Academy Referral: Teacher School Directory School Directory: Boarding School Review School Directory: Bunting & Lyon Blue Book Private School Directory: Peterson's Guide School Directory: Secondary School Admission Test School Directory: Southeastern Association of Boar School Directory: The Association of Boarding Scho Student Referral Web Site Web Site: Darlington's Web site Web Site: Other Web site Web Site: Search engine Web Site: www.gatennis.com Web Site: www.kytennis.com Web Site: www.petersons.com Web Site: www.southerntennis.com Web Site: www.studyusa.com Other (please specify below)
Student Interests (check at least one)
Soccer Academy Tennis Academy  Art  Band  Baseball  Basketball  Cheerleading  Choral  Creative Writing  Crew  Cross Country  Dance  Drama  Football	Golf  Lacrosse  Learning Center  Outdoors Programs  Piano  Publications  Scholarship Nominee  Soccer  Softball  Swimming and Diving  Tennis  Track and Field  Volleyball  Wrestling
Other questions or comments?

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