Request More Information Please fill out this form and a Wentworth admissions rep will be in contact with you shortly. Interested In*High SchoolCollegeCollege Choices*Boarding CadetCommuterHigh School Choices*7 Day Boarding Cadet5 Day Boarding Cadet (Monday-Friday)Day CadetSummer CampWhich campus are you interested in attending?*LexingtonCameronOn Line Classes OnlyWhat academic year do you plan on enrolling?*2016-172017-182018-19What grade level will you be enrolling070809101112What grade level will you be enrolling?*09101112What term do you plan on enrolling?*FallSpringSummerWhat term do you plan on enrolling?*FallSpringWhat summer do you plan to attend*201720182019Which session are you interested in attending?*Camp LEAD (5 Weeks)Camp LEAD (3 Weeks)Intensive ESL (3 Weeks)What grade is the student currently in?*06070809101112Are you looking to earn a degree or are you non degree seeking?Associate of ArtsAssociate of ScienceNon Degree SeekingName of Individual Filling out this Form*Relation to the ApplicantParentGuardianOtherPrimary Parent/Guardian Primary Phone*Student's Last Name*Student's First Name*Last Name*First Name*Email - Please enter the email address you would like to be contacted at* Primary Phone*Address*City*State*AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificOtherZip/Postal CodeCounty*Gender*MaleFemaleBirth Date*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920If you are interested in playing a sport, please mark your primary sport choice (one sport only please) Men's Basketball Women's Basketball Men's Soccer Women's Volleyball Men's Wrestling Women's Wrestling Baseball Cross Country Band SROTC ECP Check all sports/activities you would be interested in participating Football Volleyball Boy's Basketball Girl's Basketball Men's Wrestling Track & Field Cross Country Tennis Band How did you hear about Wentworth Military Academy & College?*CaptchaPhoneThis field is for validation purposes and should be left unchanged.