APPLICATION-123

    Applicant Information

    Upload Student Photo *

    Student Name *

    Preferred First Name (optional)

    Street Address *

    Zip *

    City *

    Country *

    Student Date of Birth *

    Student Email Address *

    How did you hear about us? *

    Student Cell Phone *

    Student Gender *

    [radio* student-gender use_label_element "Male" "Female" "Other"]

    Student Citizenship *

    Primary Language Spoken at Home *

    Birth City *

    Birth Country *

    Is the applicant a dual citizen? *

    [radio* dual_citizen "Yes" "No"]

    Mailing address (if different)

    Day or Boarding Student? *

    [radio* student-type use_label_element "Day" "Boarding"]

    Previous Schools

    Most Recent School Attended (optional)

    School Name *

    Street Address *

    City *

    Zip *

    Phone *

    From Date *

    To Date *

    Grade Completed *

    Additional Student Information

    Has your child ever received formal disciplinary action? *

    [radio* discipline use_label_element "Yes" "No"]

    Is your child eligible to return to current/previous school? *

    [radio* eligible-return use_label_element "Yes" "No"]

    Has your child ever been involved with legal authorities? *

    [radio* involved-authorities use_label_element "Yes" "No"]

    Has your child ever been involved with drugs, alcohol or tobacco? *

    [radio* substance-use use_label_element "Yes" "No"]

    Has your child ever had any educational or psychological testing? *

    [radio* testing use_label_element "Yes" "No"]

    Has your child ever received counseling? *

    [radio* counseling use_label_element "Yes" "No"]

    Custody Questionnaire – Household 1

    Street Address *

    City *

    Country *

    Home Phone *

    First Parent / Guardian (optional)

    Last Name

    First Name

    Salutation

    Gender

    Relationship to Applicant

    Custodial Rights? *

    Financial Responsibility? *

    Receive Correspondence? *

    Marital Status

    Email Address

    Work Phone (optional)

    Cell Phone *

    Occupation

    Employer

    Employer Address (optional)

    Household 2

    Does the applicant have a parent/guardian at another address? *

    Second Parent / Guardian (optional)

    Last Name

    First Name

    Salutation

    Gender

    Relationship to Applicant

    Custodial Rights?

    Financial Responsibility?

    Receive Correspondence?

    Marital Status

    Email Address

    Work Phone

    Cell Phone

    Occupation

    Employer

    Employer Address

    Siblings (if any)

    Sibling Name

    Age

    Date of Birth

    Gender

    Grade

    Current School

    Parent Questionnaire

    Please describe your child *

    Student Questionnaire and Essay

    Describe yourself in your own words *

    List three adjectives your friends would use *

    Describe the classroom environment for your maximum potential *

    Parent/Student Agreement

    I have read and agree to the policies and practices *