Please complete the required fields below in order to get on our mailing list and receive an application packet for admission to Harvard-Westlake. If you have received an application and would like additional forms, please call the admission office at 310-288-3200 or download the forms here.

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Student Information

First Name Middle Name Last Name Gender MaleFemale Current School Birth Date (mm/dd/yyyy) Applying for Grade For Fall of   Select one... 7 8 9 10 11 Select one... 2009 2010 2011 2012 Has this student applied to Harvard-Westlake in the past? YesNo

Parent Information

Title Gender Relationship to Student Select one... Mr. Mrs. Ms. Miss Dr. MaleFemale Select one... father mother stepfather stepmother grandparent guardian Parent First Name Parent Middle Name Parent Last Name Parent Email

Parent 2 Information

Title Gender Relationship to Student Select one... Mr. Mrs. Ms. Miss Dr. MaleFemale Select one... father mother stepfather stepmother grandparent guardian Parent 2 First Name Parent 2 Middle Name Parent 2 Last Name Parent 2 Email Married to the parent above?

Address where you'd like information sent

Address (line 1)

Address (line 2)

City State Zip Code <Select one...> Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

Home Phone

Does this applicant have any siblings who currently attend Harvard-Westlake?

YesNo

Names of attending siblings:

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