Saint Bernard Preparatory School

Transcription

1 Saint Bernard Preparatory School APPLICATION FOR ADMISSION Attach your most recent photo here Please PRINT Date: Gender: ofemale omale Applying for Grade Requesting Admission for: ofall ospring of What Year: Intended Status as a Student: oday Only o5-day Boarding o7-day Boarding Applicant s Name: first middle last Called (nickname?) Home Address: number & street city state province/territory postal code/zip country Contact: Home Phone Cell Phone Date of Birth: Place of Birth: month day year city state country Social Security#: Religious Affiliation: oroman Catholic oother Citizen of: ou.s.a. oother Race: ocaucasion oblack ohispanic oasian oother Applicant Has a Disability with regard to (Please check All that apply to the Applicant): ospeech/language ohearing opsychological ovision oother Please explain on an attached sheet and include a copy of any evaluation that has been made. Full Name of: ofather ostepfather oguardian Address (if different from Applicant s): Contact: Home Phone Cell Phone Work Phone Fax Business Address: Occupation: Employer: Highest Level of Education: Religious Affiliation: Full Name of: omother ostepmother oguardian Address (if different from Applicant s): Contact: Home Phone Cell Phone Work Phone Fax Business Address: Occupation: Employer: Highest Level of Education: Religious Affiliation: APPLICATION for ADMISSION Revised February 2015 Page 1 of 2

2 Applicant s Parents are (Please Check All that Apply): omarried odivorced oseparated omother remarried ofather remarried omother deceased ofather deceased Applicant presently lives with: Send correspondence to: Person(s) financially responsible for Applicant (this debt is non-dischargeable in bankruptcy): Names and ages of Applicant s brothers and sisters: Relatives who attended St. Bernard: School(s) Applicant has attended during last two years: School Name Address Phone Grade Name of current Principal: APPLICANT MUST COMPLETE THE FOLLOWING IN HIS or HER OWN HANDWRITING! On a separate piece of paper, give your reason(s) for wanting to attend St. Bernard Preparatory School. Attach to this Application before submitting to Office of Admissions. Signature of Applicant: Signature of Parent(s) or Guardian(s): (MUST be provided) APPLICATION CHECKLIST o CAMPUS VISIT & PERSONAL INTERVIEW (may be waived because of extreme distance) o APPLICATION FOR ADMISSION fully completed, signed by Applicant and Parent/Guardian o PHOTO OF APPLICANT (attached to front of application) o APPLICATION FEE MUST ACCOMPANY THIS APPLICATION (non refundable) $50 Domestic $100 International o PARENT/GUARDIAN QUESTIONNAIRE fully completed (non refundable) o ENGLISH TEACHER RECOMMENDATION FORM from appropriate teacher (current or most recent) o MATH TEACHER RECOMMENDATION FORM from appropriate teacher (current or most recent) o COUNSELOR/PRINCIPAL RECOMMENDATION FORM (current or most recent) o REPORT CARDS or GRADE TRANSCRIPTS FOR LAST TWO YEARS (unofficial is acceptable temporarily) o ACHIEVEMENT TEST SCORES FROM TWO MOST RECENT YEARS o INTERNATIONAL APPLICANTS: oproficiency IN ENGLISH LANGUAGE (SLEP or TOEFL Scores AND oral evaluation by Admissions Office Personnel) oofficial IMMUNIZATIONS RECORD (Hepatitis, Polio, Varicella, etc.) Immunizations MUST BE COMPLETED, and official document sent to St. Bernard BEFORE arrival in the U.S.A. When the above checklist items are received, the Admissions Committee will review this Application and notify you of a decision within two weeks. Immunization records are not required for application; they are due as noted above. Please /fax/mail this completed form to St. Bernard Preparatory School, using the address information below. Office of Admissions Saint Bernard Preparatory School Saint Bernard Preparatory School abides by both the spirit and the letter of the law in all its employment and admission policies. The school does not discriminate on the basis of race, religion, gender, sexual orientation, nationality, or ethnic origin. APPLICATION FOR ADMISSION Revised February 2015 Page 2 of 2

3 Saint Bernard Preparatory School PARENT/GUARDIAN QUESTIONNAIRE Please PRINT as you thoroughly answer the following questions; if you need additional space, please attach another sheet of paper. Applicant s Name: first middle last Called (nickname?) Your Relationship to Applicant: Full Name of Parent(s)/Guardian(s) who is/are completing this Questionnaire: 1. Why are you considering St. Bernard Preparatory School for your son/daughter/ward? 2. What are the applicant s academic strengths? 3. What are the applicant s academic weaknesses? 4. Describe the applicant s interactions with peers and adults. 5. Describe the applicant s learning style and/or the environment in which he/she best learns. 6. Has the applicant ever had an educational or psychological evaluation? oyes ono Date: 7. Has the applicant ever been tested for a learning disability, ADD or ADHD? oyes ono Date: PARENT/GUARDIAN QUESTIONNAIRE Revised February 2015 Page 1 of 2

4 8. Is the applicant currently taking prescribed medications? oyes ono If yes, please list and describe the purpose of the medication(s)? 9. Has the applicant seen a counselor, therapist, psychologist, or psychiatrist? oyes ono Date(s): If yes, please list and describe the nature of the session(s) and current prognosis. 10. Has the applicant ever been admitted or recommended to a residential treatment or therapeutic facility? oyes ono If yes, please explain and provide date(s) and contact information. 11. Should your son/daughter/ward be accepted into St. Bernard Preparatory School, what would you hope is accomplished? My/Our signature(s) below confirm(s) that all information given is correct to the best of my/our knowledge. I/We understand that any omission, misrepresentation of facts, and/or falsifying or withholding information in completing this questionnaire, as well as all required documents of the application package, constitutes grounds for immediate withdrawal of the application, cancellation of admission, and/or termination of enrollment by St. Bernard Preparatory School. Further, I/we understand that upon enrollment, I/we are expected to abide by the rules and regulations set forth in the St. Bernard Preparatory School Student-Parent Handbook. Signature(s) of Custodial Parent(s) or Guardian(s): Date: Date: Signature of Applicant: Date: Please /fax/mail this completed form to St. Bernard Preparatory School, using the address information below. Office of Admissions Saint Bernard Preparatory School Saint Bernard Preparatory School abides by both the spirit and the letter of the law in all its employment and admission policies. The school does not discriminate on the basis of race, religion, gender, sexual orientation, nationality, or ethnic origin. PARENT/GUARDIAN QUESTIONNAIRE Revised February 2015 Page 2 of 2

5 TO THE STUDENT: Saint Bernard Preparatory School ENGLISH RECOMMENDATION CONFIDENTIAL Please print your name and school below and give this form and a stamped envelope to your current English teacher. The envelope must be addressed to: Office of Admissions, St. Bernard Preparatory School, 1600 St. Bernard Drive SE, Cullman, AL Full Name of Student Name of Current School TO THE ENGLISH TEACHER: The student named above is a candidate for admission to St. Bernard Preparatory School. The Admission Committee places considerable weight on the academic and personal qualifications of each applicant. This personal recommendation from you is vital to our process. Your comments and evaluation are used for admission purposes only and will not become a part of the candidate s permanet school record should he/she be admitted. How long have you known the applicant? Course title(s) taught to the applicant by you? Textbook title(s) & edition used for the course(s): Content (circle as appropriate): Grammar Vocabulary Composition Literature Literary Analysis Other Ability level of this course (circle one): Honors College-Preparatory Regular Not Sectioned Other Please check the boxes of those courses which the student will have completed by the end of the current school year: o English 7th Grade o English 8th Grade o English 9th Grade o English 10th Grade o English 11th Grade o Other: What adjectives or phrases come to mind in describing the applicant? Please note weaknesses & strengths. English Teacher Recommendation Revised February 2015 Page 1 of 2

6 Saint Bernard Preparatory School is a competitive college-preparatory day and boarding school, offering grades 7 through 12. Emphasis is placed on academic achievement and active involvement in the school community. In relation to other students you have known, please evaluate this student in the following areas to the best of your ability: If the applicant rates below average in any area, please elaborate: I recommend this student for admision to St. Bernard Preparatory School (please circle one): Enthusiastically Without Reservation With Reservation Not at All Signature: Date: Printed Name: Title: School Address (Street address, city, state, zip): Telephone: Thank you for taking your valuable time to complete this evaluation. The applicant has no access to Admissions Office records. The information you have provided is confidential. Please seal this completed form in the stamped, addressed envelope provided by the student and mail at your earliest convenience. You may also FAX this form to Office of Admissions Saint Bernard Preparatory School Saint Bernard Preparatory School abides by both the spirit and the letter of the law in all its employment and admission policies. The school does not discriminate on the basis of race, religion, gender, sexual orientation, nationality, or ethnic origin. English Teacher Recommendation Revised February 2015 Page 2 of 2

7 TO THE STUDENT: Saint Bernard Preparatory School MATHEMATICS RECOMMENDATION CONFIDENTIAL Please print your name and school below and give this form and a stamped envelope to your current math teacher. The envelope must be addressed to: Office of Admissions, St. Bernard Preparatory School, 1600 St. Bernard Drive SE, Cullman, AL Full Name of Student Name of Current School TO THE MATH TEACHER: The student named above is a candidate for admission to St. Bernard Preparatory School. The Admission Committee places considerable weight on the academic and personal qualifications of each applicant. This personal recommendation from you is vital to our process. Your comments and evaluation are used for admission purposes only and will not become a part of the candidate s permanet school record should he/she be admitted. How long have you known the applicant? Course title(s) taught to the applicant by you? Textbook title(s) & edition used for the course(s): Content (circle as appropriate): General Math Pre-Algebra Algebra I Geometry Algebra II Trigonometry Pre-Calculus Calculus Other Ability level of this course (circle one): Honors College-Preparatory Regular Not Sectioned Other Please check the boxes of those courses which the student will have completed by the end of the current school year: o Grade 7 Math o Pre-Algebra o Algebra I oquadratic Equations & Functions oright Triangle Trig oradical Equations & Functions orational Equations & Functions oother: o Geometry o Algebra II oanalytical Trigonometry o Pre-Calculus o Calculus o AP Calculus oab obc o Other: What adjectives or phrases come to mind in describing the applicant? Please note weaknesses & strengths. Math Teacher Recommendation Revised February 2015 Page 1 of 2

8 Saint Bernard Preparatory School is a competitive college-preparatory day and boarding school, offering grades 7 through 12. Emphasis is placed on academic achievement and active involvement in the school community. In relation to other students you have known, please evaluate this student in the following areas to the best of your ability: If the applicant rates below average in any area, please elaborate: I recommend this student for admision to St. Bernard Preparatory School (please circle one): Enthusiastically Without Reservation With Reservation Not at All Signature: Date: Printed Name: Title: School Address (Street address, city, state, zip): Telephone: Thank you for taking your valuable time to complete this evaluation. The applicant has no access to Admissions Office records. The information you have provided is confidential. Please seal this completed form in the stamped, addressed envelope provided by the student and mail at your earliest convenience. You may also FAX this form to Office of Admissions Saint Bernard Preparatory School Saint Bernard Preparatory School abides by both the spirit and the letter of the law in all its employment and admission policies. The school does not discriminate on the basis of race, religion, gender, sexual orientation, nationality, or ethnic origin. Math Teacher Recommendation Revised February 2015 Page 2 of 2

9 TRANSCRIPT REQUEST and COUNSELOR/PRINCIPAL RECOMMENDATION CONFIDENTIAL TO THE STUDENT: Saint Bernard Preparatory School Please print your name and school below and give this form and a stamped envelope to your current counselor or principal. The envelope must be addressed to: Office of Admissions, St. Bernard Preparatory School, 1600 St. Bernard Drive SE, Cullman, AL Full Name of Student Name of Current School TO THE COUNSELOR or PRINCIPAL: The student named above is a candidate for admission to St. Bernard Preparatory School. The Admission Committee places considerable weight on the academic and personal qualifications of each applicant. This personal recommendation from you is vital to our process. Your comments and evaluation are used for admission purposes only and will not become a part of the candidate s permanet school record should he/she be admitted. Please complete this form and return it with the following: * current official school transcript * complete record of standardized testing * current year s course of study with current grades * school profile What is the minimum passing grade in your school? What range of grades constitutes honors work? In what honors classes is this student presently enrolled? How long and in what capacity have you known the applicant? What adjectives or phrases come to mind in describing the applicant? Please note weaknesses & strengths. Counselor/Principal Recommendation Revised February 2015 Page 1 of 2

10 Saint Bernard Preparatory School is a competitive college-preparatory day and boarding school, offering grades 7 through 12. Emphasis is placed on academic achievement and active involvement in the school community. In relation to other students you have known, please evaluate this student in the following areas to the best of your ability: If the applicant rates below average in any area, please elaborate: I recommend this student for admision to St. Bernard Preparatory School (please circle one): Enthusiastically Without Reservation With Reservation Not at All Signature: Date: Printed Name: Title: School Address (Street address, city, state, zip): Telephone: Thank you for taking your valuable time to complete this evaluation. The applicant has no access to Admissions Office records. The information you have provided is confidential. Please seal this completed form in the stamped, addressed envelope provided by the student and mail at your earliest convenience. You may also FAX this form to Office of Admissions Saint Bernard Preparatory School Saint Bernard Preparatory School abides by both the spirit and the letter of the law in all its employment and admission policies. The school does not discriminate on the basis of race, religion, gender, sexual orientation, nationality, or ethnic origin. Counselor/Principal Recommendation Revised February 2015 Page 2 of 2