Lumin Education Inquiry Form

Thank you for your interest in Lumin Education! We look forward to learning more about you and your family. Please fill out the form below and we'll get back to you.

Your Name (First and Last)*

Answer required for "Your Name (First and Last)"

Prospective Student Information

Student First Name*

Answer required for "Student First Name"

Student Last Name*

Answer required for "Student Last Name"

Student Date of Birth*

Answer required for "Student Date of Birth"

Parent/Guardian Contact Information

First Name*

Answer required for "First Name"

Last Name*

Answer required for "Last Name"

Email*

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Phone*

Number Required

Questions/Comments*

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How do you prefer we follow up with you?*

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Phone

What language do you prefer to communicate in?*

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English

Spanish

Please fix the highlighted areas below before submitting.

Lumin Education Inquiry Form