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Shadow at Mercy Form
This form requires Javascript to be enabled for submission and authorization.
*
Required
Student Name
*
required
"Preferred Name" will be used on your student's name tag for her shadow visit.
First Name
Preferred Name
Last Name
"Preferred Name" will be used on your student's name tag for her shadow visit.
Current School
*
required
Current Grade
*
required
7
8
9
10
11
Mercy's Director of Admissions and Marketing, Emily McCullough, will reach out to you by phone to gather additional information about your student's transfer request.
Student Date of Birth
*
required
Must contain a date in M/D/YYYY format
Parent/Guardian Name
*
required
First Name
Last Name
Parent/Guardian Email Address
*
required
Please select your desired month to shadow
November
December
Please select your desired date to shadow
*
required
Thursday, November 7
Friday, November 8
Tuesday, November 12
Wednesday, November 13
Thursday, November 14
Friday, November 15
Monday, November 18
Tuesday, November 19
Wednesday, November 20
Thursday, November 21
Friday, November 22
Please select your desired date to shadow
*
required
Monday, December 2
Tuesday, December 3
Wednesday, December 4
Thursday, December 5
Friday, December 6
Monday, December 9
Tuesday, December 10
Wednesday, December 11
Thursday, December 12
Is there a current student at Mercy that you would like to shadow?
*
required
Yes
No
Please provide the name of the student you want to shadow
*
required
Home Address
*
required
City
*
required
State
*
required
Zip Code
*
required
Parent/Guardian Phone Number
*
required
T-Shirt Size
Please select the academic level(s) you would like for your student to experience during her shadow visit:
Advanced - Independent and fast-paced classroom that focuses on conceptualization and critical thinking skills.
Honors 1 - Rigorous college-prep curriculum that challenges students considering advanced or AP coursework in the future
Honors 2 - Individualized college-prep curriculum that challenges students to meet the demands of the 21st century by focusing on collaboration and problem solving.
Academic - Highly structured and individualized classroom experience that emphasizes content mastery.
Classes your student is interested in seeing
We aim to fulfill all requests, however, can't guarantee your student will see all classes listed.
Clubs/Sports your student would like to learn more about
Are you interested in taking a tour of Mercy's campus on the day of your student's shadow visit?
Yes
No
Is the parent/guardian of the student shadowing an alumna of Mercy Academy?
Yes
No
Name
*
required
First Name
Maiden (optional)
Last Name
Graduation Year
Special Needs/Accommodations/Allergies (please list below if applicable)
How did you hear about Mercy Academy?
*
required
(Student's School, Facebook, Instagram, TV Advertisement, Word of Mouth, etc.)
What prompted you to sign your student up for a shadow visit at Mercy?
*
required
(Email, Facebook, Student Request, etc.)
Additional Comments
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