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Request Information

It is a pleasure to welcome you to Adventist Education Simi Valley Elementary School. We would be delighted to have your child(ren) join our community.

Please fill out the form below and our Admissions Office will contact you to schedule a visit at our school, to meet our faculty, and to learn more about what sets us apart.

Thank you for your interest in our school!

* Indicates a required field.

Parent / Guardian Information
  • First Parent / Guardian
  • First Name *
  • Middle Name
  • Last Name *
  • Salutation *
  • Email Address *
  • Confirm Email Address *
  • Gender
  • Work Phone
  • Cell Phone
  • Second Parent / Guardian
    (leave blank if not applicable)
  • First Name *
  • Middle Name
  • Last Name *
  • Salutation *
  • Email Address *
  • Confirm Email Address *
  • Gender
  • Work Phone
  • Cell Phone
Home Address
  • Street Address
  • City
  • Country
  • State
  • Zip
  • Home Phone
  • How Did You Hear About Us?
    Details:
  •  
  • Student 1
  • First Name *
    Middle Name
    Last Name *
  • Birthdate
    (mm/dd/yyyy)
    Gender
  • Email Address
    Confirm Email Address
  • Grade Level of Interest *
    School Year *
  • Current School
  •  
  • Is There Another Student?
    Yes No
  •