BOARDING SCHOOL APPLICATION

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1 BOARDING SCHOOL APPLICATION Educatius International 22 Batterymarch Street Boston, MA Phone: Fax: TO THE SCHOOL: THIS APPLICATION IS BEING SUBMITTED THROUGH EDUCATIUS DATE STUDENT S FULL NAME (FIRST/MIDDLE/LAST) IF ACCEPTED, PLEASE ACCEPTANCE PACKAGE TO EDUCATIUS CREDIT CARD INFORMATION PLEASE PROVIDE A CREDIT CARD FOR THE SCHOOL S APPLICATION FEE. IF YOU PREFER TO PAY THIS BY BANK DRAFT/CHECK, PLEASE INDICATE THIS. CARD TYPE CARD NUMBER NAME AS IT APPEARS ON THE CARD CARD EXPIRATION DATE SECURITY CODE AS IT APPEARS ON THE BACK WILL PAY BY BANK DRAFT/CHECK AND IT WILL BE INCLUDED WITH THE HARD COPY TO BE MAILED DIRECTLY TO THE SCHOOL

2 STUDENT APPLICATION PAGE 1 OF 3 STUDENT INFORMATION, TYPE OR PRINT WITH BLACK INK ONLY DATE STUDENT S FULL NAME (FIRST/MIDDLE/LAST) NAME YOU ARE CALLED HOME ADDRESS POSTAL ZONE HOME TELEPHONE SKYPE ID SEX MALE FEMALE DATE OF BIRTH (MONTH/DAY/ YEAR) OF BIRTH OF BIRTH PASSPORT NO. ISSUING PASSPORT EXPIRATION GRADE APPLYING FOR ACADEMIC YEAR BEGINNING FALL 20 SPRING 20 PROGRAM GOALS PRIVATE BOARDING FULL YEAR ONE SEMESTER CURRENT SCHOOL INFORMATION CURRENT SCHOOL PUBLIC PAROCHIAL PRIVATE DATES ATTENDED FROM TO PRESENT GRADE ADDRESS (STREET) POSTAL CODE PRINCIPAL /COUNSELOR PHONE FAX PREVIOUS SCHOOL PUBLIC PAROCHIAL PRIVATE DATES ATTENDED FROM TO GRADE IS STUDENT WILLING TO ENTER A LOWER GRADE TO MEET REQUIREMENTS OF THE SPECIFIED SCHOOL? YES NO STANDARDIZED TEST RESULTS (PLEASE ATTACH ACTUAL RESULTS TO THE APPLICATION) SLEP TOEFL TOEFL Junior ITEP SLATE IELTS SSAT OTHER

3 STUDENT APPLICATION PAGE 2 OF 3 STUDENT S FAMILY, TYPE OR PRINT WITH BLACK INK ONLY RELIGIOUS PREFERENCE INTEREST AND INVOLVEMENT ACTIVE LITTLE NONE WHO DO YOU LIVE WITH MOTHER AND FATHER MOTHER FATHER OTHER (WHO) FATHER OR LEGAL GUARDIAN NAME (FIRST/MIDDLE/LAST) STREET POSTAL ZONE HOME TELEPHONE OCCUPATION WORK TELEPHONE MOTHER OR LEGAL GUARDIAN NAME (FIRST/MIDDLE/LAST) STREET POSTAL ZONE HOME TELEPHONE OCCUPATION WORK TELEPHONE BROTHERS AND SISTERS NAME AGE SEX MALE FEMALE LIVE AT HOME YES NO NAME AGE SEX MALE FEMALE LIVE AT HOME YES NO LIST FOREIGN LANGUAGES YOU SPEAK OR HAVE STUDIED LANGUAGE YEARS OF STUDY PROFICIENCY English AVERAGE GOOD EXCELLENT AVERAGE GOOD EXCELLENT MY NATIVE LANGUAGE IS

4 STUDENT APPLICATION PAGE 3 OF 3 SMOKING I DO NOT SMOKE I SMOKE OCCASIONALLY, BUT AGREE TO STOP SMOKING COMPLETELY WHILE IN THE US I SMOKE DOES THE STUDENT HAVE ANY SPECIFIC MEDICAL PROBLEMS/REQUIREMENTS? LIST HOBBIES, INTERESTS (INCLUDING SPORTS, MUSIC, ART) THAT YOU ENJOY AS A PARTICIPANT OR SPECTATOR HAVE YOU PARTICIPATED IN A LONG TERM (SEMESTER/YEAR) STUDY ABROAD PROGRAM IN THE US BEFORE? IF SO, WHEN? WHERE? COMPANY? HAVE YOU EVER SPENT AN EXTENDED TIME AWAY FROM YOUR FAMILY? IF SO, PLEASE DESCRIBE THIS EXPERIENCE PERSONALITY TRAITS, CHECK THE FOLLOWING WORDS THAT BEST DESCRIBE YOU POLITE RESPONSIBLE RESERVED CASUAL INFORMAL SHY SENSITIVE OPTIMISTIC INSECURE EMOTIONAL FRIENDLY ACTIVE SPONTANEOUS QUICK-TEMPERED INDEPENDENT OPEN NEAT PATIENT SERIOUS ADAPTABLE CALM DESCRIBE YOURSELF IN YOUR OWN WORDS

5 PERSONAL ESSAY PAGE 1 OF 1 MUST BE TYPEWRITTEN. PLEASE TYPE AND GIVE A HANDWRITTEN AT THE END. PLEASE DO NOT DOUBLE SIDE THE PAGES AND DO NOT STAPLE. STUDENT S NAME (FIRST/MIDDLE/LAST) ADDRESS (STREET) POSTAL ZONE HOME TELEPHONE (INCLUDE AREA CODE) PROVIDE A DETAILED DESCRIPTION OF YOUR LIFE (LIFESTYLE, HOBBIES, INTERESTS, SCHOOL), YOUR PARENTS, YOUR BROTHERS AND SISTERS. STATE YOUR MOTIVATION FOR BECOMING A STUDENT IN ANOTHER. WHAT ARE YOUR GOALS IN THE AREAS OF SCHOOL, AND SOCIALLY (FRIENDS, CLUBS, SPORTS OUTSIDE OF SCHOOL).

6 PHOTO ALBUM PAGE 1 OF 1 NAME HOME ATTACH PHOTOGRAPHS OF YOU, YOUR FAMILY, AND FRIENDS DOING WHAT YOU ENJOY AND IN PLACES WHERE YOU LIVE. THESE PHOTOGRAPHS GREATLY HELP UNDERSTAND WHAT YOUR LIFE IS LIKE IN YOUR HOME. DESCRIBE EACH PHOTO IN THE SPACE.

7 PROGRAM RULES FOR EDUCATIUS INTERNATIONAL STUDENTS 1 There will be dormitory rules on the campus the student will be residing, and the student is expected to follow the guidelines set forth by the school. 2 The use of drugs for non-medical reasons by Educatius International students under any circumstances is strictly forbidden. Educatius International students may not buy, sell, or posses any controlled and/or illegal drug, unless it is prescribed and approved by the student s physician. 3 It is against U.S. law for persons under the age of 21 to buy or use alcohol. 4 The legal age for buying and smoking cigarettes and other tobacco products in the U.S. is 18. However, school dormitories prohibit using tobacco products on school grounds and in the dormitories. 5 Students on the Educatius International Program are not permitted to hitchhike under any circumstances. 6 Students may not make any life-changing decisions while on the program. This includes marriage, changing religion, body piercing or tattoos. 7 All Travel must be approved by the school office 30 days in advance by submitting a Travel Release Form with the proper signatures. Students may not miss school to travel unless they are traveling on a school approved trip. 8 The students have the ability to travel and receive visits, as long as it does not interfere with academics and school attendance and is approved by the school in advance. The school is NOT responsible for handling any travel arrangements for the student or the student s visitors. Visitors must find a Hotel/Motel. The student must coordinate with the school and make sure they know Educatius International 22 Batterymarch Street Boston, MA Phone: Fax: the students location and contact information while the student is traveling or staying with visitors at a location other than the school. 9 Students must obey the rules and regulations of the high school in which they attend. Attendance at school is mandatory, unless a student is ill or has been approved to travel under the guidelines of #7. Students are required to enroll in a full course load, including English. Students should maintain a minimum of a C average in each class. Failure to do so, and/or repeated complaints from the school regarding poor attitude or behavior, are grounds for dismissal from the program. 10 Students under U.S. Naturalization and Immigration regulations are prohibited from accepting any form of competitive employment. 11 Regulations for obtaining driver s licenses vary from state to state, and this is not promised to Educatius International students. The ONLY vehicle Educatius International students are permitted to drive while on the Educatius International program is an authorized driver s educational vehicle and only when the student is taking an accredited driver education class. Under NO circumstances can Educatius International students drive a vehicle or anyone else s vehicle. If you are able to obtain a driver s license, you are still NOT allowed to drive. 12 While in the US, Educatius International students are under the jurisdiction of local, state, and federal laws. 13 Educatius International students must obey the decisions of the school staff members at all times. Educatius International officials will make right to make all final decisions. TODAY S OF STUDENT APPLICANT OF MOTHER OR LEGAL GUARDIAN OF FATHER OR LEGAL GUARDIAN

8 RECOMMENDATION LETTER PAGE 1 OF 1 ENGLISH TEACHER RECOMMENDATION LETTER, PRINT OR TYPE IN ENGLISH TO THE STUDENT: Please print your name and grade and sign below. Give a copy of this page to your teacher. Please attach scanned copies of the signed reference letters. STUDENT NAME APPLYING FOR GRADE TO THE PARENTS: Please read and sign. I acknowledge that I waive my right to read the confidential teacher recommendation letter and report for my child listed above. NAME OF PARENT OR GUARDIAN RELATIONSHIP TO STUDENT TO THE ENGLISH TEACHER: In order to gain a better assessment of the student s English language abilities, we require a recommendation letter from the applicant s English teacher. The letter should outline the student s abilities in the following areas: reading, writing, speaking and comprehension. It should also highlight the student s general attitude and whether or not the teacher recommends the student for studies in the us. This recommendation letter should include the teacher s name, school, address and contact information. Please complete the following and attach your recommendation letter. You may provide the student with a copy if you so wish. Otherwise your input will be kept confidential. Please mail in the attached envelope. NAME OF STUDENT HOW WELL DO YOU KNOW THIS STUDENT? IN WHAT YEARS DID YOU TEACH THE STUDENT? WHAT COURSE? PLEASE DESCRIBE YOUR COURSE. HOW IS THE STUDENT S COMPREHENSION LEVEL? HOW DOES THE STUDENT COMPARE TO OTHERS IN THE CLASS? TEACHER S NAME NAME OF SCHOOL SCHOOL ADDRESS TELEPHONE NUMBER ADDRESS

9 RECOMMENDATION LETTER PAGE 1 OF 1 MATH TEACHER RECOMMENDATION LETTER, PRINT OR TYPE IN ENGLISH TO THE STUDENT: Please print your name and grade and sign below. Give a copy of this page to your teacher. Please attach scanned copies of the signed reference letters. STUDENT NAME APPLYING FOR GRADE TO THE PARENTS: Please read and sign. I acknowledge that I waive my right to read the confidential teacher recommendation letter and report for my child listed above. NAME OF PARENT OR GUARDIAN RELATIONSHIP TO STUDENT TO THE MATH TEACHER: In order to gain a better assessment of the student s math and analytical abilities, we require a recommendation letter from the applicant s math teacher. The letter should outline the student s abilities in mathematics. It should also highlight the student s general attitude and whether or not the teacher recommends the student for studies in the us. This recommendation letter should include the teacher s name, school, address and contact information. Please complete the following and attach your recommendation letter. You may provide the student with a copy if you so wish. Otherwise your input will be kept confidential. Please mail in the attached envelope. NAME OF STUDENT HOW WELL DO YOU KNOW THIS STUDENT? IN WHAT YEARS DID YOU TEACH THE STUDENT? WHAT COURSE? PLEASE DESCRIBE YOUR COURSE. HOW IS THE STUDENT S KNOWLEDGE OF THE MATERIAL AND ANALYTICAL SKILLS? HOW DOES THE STUDENT COMPARE TO OTHERS IN THE CLASS? TEACHER S NAME NAME OF SCHOOL SCHOOL ADDRESS TELEPHONE NUMBER ADDRESS

10 RECOMMENDATION LETTER PAGE 1 OF 1 OTHER RECOMMENDATION LETTER, PRINT OR TYPE IN ENGLISH TO THE STUDENT: Please print your name and grade and sign below. Give a copy of this page to your teacher. Please attach scanned copies of the signed reference letters. STUDENT NAME APPLYING FOR GRADE TO THE PARENTS: Please read and sign. I acknowledge that I waive my right to read the confidential teacher recommendation letter and report for my child listed above. NAME OF PARENT OR GUARDIAN RELATIONSHIP TO STUDENT TO THE OTHER TEACHER, COACH OR FRIEND: In order to give the school a better understanding of the applicant, a third recommendation letter is required from another teacher, counselor, coach or close family friend. The letter should outline the student s attitude, talents and/or personality. This recommendation letter should include the name, relationship to the student, address and contact information. When completed, please sign and date and mail it in the attached envelope. You may provide the student with a copy if you so wish. Otherwise your input will be kept confidential. NAME OF STUDENT RELATIONSHIP TO THE STUDENT HOW WELL AND HOW LONG HAVE YOU KNOWN THE APPLICANT? DO YOU KNOW OF ANY MEDICAL CONDITIONS THAT MIGHT PUT THIS APPLICANT S HEALTH AT RISK? PLEASE SELECT YOUR RECOMMENDATION OF THIS STUDENT AS A CANDIDATE FOR STUDY OVERSEAS. I HIGHLY RECOMMEND THIS APPLICANT FOR THE PROGRAM WITHOUT ANY RESERVATION I RECOMMEND THIS APPLICANT FOR THE PROGRAM, BUT THINK THEY NEED SOME HELP WITH: I HAVE SOME RESERVATIONS TO THIS APPLICANT S READINESS FOR TIME AWAY FROM HOME /FAMILY I DO NOT RECOMMEND THIS APPLICANT FOR THE PROGRAM IF YOU ARE AWARE OF ANY REASON WHY THIS APPLICANT SHOULD NOT BE RECOMMENDED TO PARTICIPATE IN THIS EXCHANGE PROGRAM, PLEASE EXPLAIN BELOW. ADDITIONAL COMMENTS NAME ADDRESS TELEPHONE NUMBER ADDRESS

11 Educatius International 22 Batterymarch Street Boston, MA Phone: Fax: GUARANTEE OF FINANCIAL RESPONSIBILITY BY PARENT OR LEGAL GUARDIAN I,, parent/legal Guardian of, hereby certify; (Full name of student) That I will assume full responsibility for any and all expenses not provided by the Educatius students but incurred by my aforementioned son or daughter while he/she resides in the country of as an Educatius student participant. PARENT/GUARDIAN NAME (TYPE OR PRINT) STREET/MAILING ADDRESS ZIP/POSTAL CODE STATE/PROVINCE DATE SIGNED (MONTH/DAY/ YEAR) PARENT/GUARDIAN

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