Cougar Mountain Academy 
 
 'for Children with High Expectations'  
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Home > Contact Us > Information Request Form

If you would like to receive additional information please
complete the following form and click submit.

STUDENT INFORMATION

Name of Student 1:
Birthdate
Sex      Male    Female
Present School/Grade


Name of Student 2:
Birthdate
Sex      Male    Female
Present School/Grade


Name of Student 3:
Birthdate
Sex      Male    Female
Present School/Grade


Home Address
City
State/Zip
Home Phone
Home E-Mail

PARENT INFORMATION

Name of Mother:
Preferred Phone
Preferred E-Mail


Name of Father:
Preferred Phone
Preferred E-Mail

INFORMATION REQUESTED
(information will be mailed to Home Address)
Summer Quarter
Fall-Winter-Spring Quarters
Electives
Tutoring
Home Schooling
Other
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COMMENTS, QUESTIONS




Cougar Mountain Academy offers a future of promise and
nurtures each student as if that child were the only one attending.
5410 194thAvenue SE    Issaquah, Washington 98027     Phone: 425-641-2800     Fax: 425-392-3565
 
© Copyright 2012 Cougar Mountain Academy