Ingenuity Year Information Request

A GAP YEAR PROGRAM BUILT FOR STUDENTS WHO LEARN DIFFERENTLY.
Ingenuity Year is for students who want to take their learning out of the classroom and engage with the world. It’s for students who want to understand who they are as learners and as humans, and who want to use that understanding to learn better. Please fill out the form below and we will be in touch with more information.

I am inquiring as a *

Student Information

First Name *

Last Name *

Gender *

Date of Birth *

Month

Day

Year

Contact Information

Parent/Guardian Name

First Name *

Last Name *

Relationship to Student *

Relationship to Student Other...

E-Mail Address *

Home Telephone

Please enter your number as XXX-XXX-XXXX

Address

Street *

Additional

City *

Country *

State / Province *

Postal Code *

Additional Information

How did you hear about Ingenuity Year? (Check all that apply)

How did you hear about Ingenuity Year? (Check all that apply) Other...

Year of Proposed Entrance *

Year of High School Graduation *

Current School