Welcome

We appreciate your interest in A Place Like Home. Kindly complete the inquiry form provided below, and we will contact you shortly. We are excited to connect with you soon.

2810 Long Ridge Road
Stamford, Connecticut 06903
(203) 890-9497

[email protected]
Mon - Fri: 8:00 AM - 6:00 PM
Sat & Sun: Closed

About The Student

About the Student (1)

First Name:

Last Name:

Preferred Name:

Gender:

Boy

Girl

Date of Birth:

Current Grade?

Interested in Grade?(Required)

Current School:(Required)

About the Parent/Guardian

First Name:(Required)

Last Name:(Required)

Relationship to Student:(Required)

Phone Number:(Required)

Email:(Required)

Mailing Address:(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Additional Information:

How Did You Hear About Us:(Required)

Who Referred You:(Required)

Phone

This field is for validation purposes and should be left unchanged.