Request a Shadow Visit 2025-26 Student Information Requested Visit Date* Dates are subject to availability. Our Admissions Department will contact you to confirm your date. Choose DateMonday, March 2Monday, March 9Monday, March 23Monday, April 20Monday, April 27 First Name* First Last Name* Last Preferred Name Suffix Date of Birth* Date Format: MM slash DD slash YYYY Gender Grade 8th Grade9th Grade10th Grade11th Grade Current School* Current School* Home Address Street Address City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Student Cell Number Your PM student ambassador will contact you prior to your Shadow Day. Parent Information Parent/Guardian #1 Name* First Last Parent/Guardian #1 Email* Parent/Guardian #1 Preferred Phone Number* Parent/Guardian #2 Name First Last Parent/Guardian #2 Email Parent/Guardian #2 Preferred Phone Number Emergency Information Please provide the following emergency contact information which will be used if a parent / guardian cannot be reached. Emergency Contact's Name* First Last Emergency Contact's Phone* Special Accommodations If your student requires any specific accommodations during their shadow visit to Purcell Marian or has specific needs, please let us know. Legacy Information Does the student have a relative (mother, father, sister, brother, aunt, uncle, or cousin) who is a graduate of Purcell Marian High School?* Yes No If yes, please provide name(s) Student Areas of Interest Check all that apply Check all that apply International Baccalaureate American Sign Language Baseball Basketball Campus Ministry Career Initiatives Program Cavalier Scholars Program Cheerleading Cross Country English Football Global Experiences History Math Music Science Service Spanish Soccer Softball Swimming Track & Field Visual Arts Volleyball Wrestling CAPTCHA
