Students in Grade 8 and transfer students are invited to experience the Mount firsthand as a Mountie for a Day! You’ll get a feel for what life as a student is like - attending classes, meeting teachers and staff, and seeing the Mount through your own eyes.

Kindly complete the questionnaire below, including the emergency contact and information form. Once you click "Submit," a member of the Admissions team will reach out to you.

Contact Cathy Bolger in the MSDA Admissions office with any questions at cbolger@msdacademy.org or 973-226-0660 Ext. 1122.

Parent Namerequired

Parent Phonerequired

Parent Emailrequired

Student Namerequired

Street Addressrequired

Townrequired

Zip Coderequired

Current Schoolrequired

Current Graderequired

What are your academic interests / current activities?required

How did you hear about the Mount?required

Do you know any current Mount Students?*

Yes No

If so, Who?

Visitor Release

The Mount is delighted to have your daughter as our guest. The following information is for emergency purposes and will be shared with our school nurse and Admissions Office on the day your daughter visits.

Student Date of Birthrequired

Emergency Contact Namerequired

Emergency Contact Phone (preferred #)required

Emergency Contact Phone (other #)required

Physician Namerequired

List Allergiesrequired

Does child administer and carry Benadryl or EPI Pen for reactions?*

Yes No

List Medications Taken Regularlyrequired

List Restrictions to Child's Activitiesrequired

Does child have medical conditions the school should be aware of?*

Yes No

List Medical Conditions required

Check the following medications your child can receive:*

In Case of Emergency

I give qualified personnel permission to treat my child. I give further permission for health related information about my child to be shared with Mount St. Dominic Academy staff on an as needed basis.

Electronic Signature for Releaserequired

Daterequired (mm/dd/yyyy)

Please send a confirmation email to the address below:

Please provide an email address where we can send a link to your current form.

Email Address :