Request Information

Want to know more about Summer at Barstow? Fill out our short form to request information or receive our catalog.

Back

Summer Inquiry Form

*Parent First Name

*Parent Last Name

*Home Address

*City

*State

*ZIP code

*Email Address

*Parent Phone Number

*Student Name

*Student Birthday

*Student's Current Grade

How did you learn about the Summer at Barstow program?

Referred by a friend/family member

Magazine Ad

Campus Signage

Online Search

Mailing

Online Ad

*Would you like our Admission Office to contact you regarding the coming academic school year?

Yes

Fax: 816-942-3227