Admission Applica on GENERAL INFORMATION

Instruc ons: This form is part of an admission applica on packet being used by most independent boarding schools
throughout the U.S., Canada, and abroad. Carefully and legibly complete this form.
Applicant Informa on

First Name Middle Name Family Name Preferred or Nickname

Home Address City State/Province Country Zip/Postal Code

Male Female
Age Date of Birth (Mo/Day/Year) Country of Birth Country of Ci zenship

Passport Number Email Address

Home Telephone (include country, city and area codes)

Resident Status: Boarding Day

Month/Year of Proposed Entrance Current Grade Applying for Grade

Parent/Guardian

Name Occupa on Name of Company

Home Address City State/Province Country Zip/Postal Code

Business Address City State/Province Country Zip/Postal Code

Business Telephone (include country, city, and area codes) Home Telephone (include country, city, and area codes)

Email Address

Parent/Guardian

Name Occupa on Name of Company

Home Address City State/Province Country Zip/Postal Code

Business Address City State/Province Country Zip/Postal Code

Business Telephone (include country, city, and area codes) Home Telephone (include country, city, and area codes)

Email Address

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 Admission Applica on GENERAL INFORMATION

Name of Student:
_________________________________________________________________

Applicant lives with? Father Mother Both Other ___________________

Where should admission materials be sent? Father Mother Both Other

___________________

Where should bills be sent? Father Mother Both Other ___________________

Check if appropriate Father Deceased Parents Divorced Father Remarried

Mother Deceased Parents Separated Mother Remarried

If parents are divorced or separated, who has legal custody of the applicant?
_______________________________________________

Are you applying for a nancial aid? Yes No

Test Scores (TOEFL of SAT, only if taken

already)______________________________________________________________________

First language, other than English language spoken in the

home__________________________________________________________

Declara on of ethnicity (op onal)

__________________________________________________________________________________

Informa on about brothers and sisters (use addi onal sheets if necessary)

Name Age School

Name Age School

Name Age School

Educa on
Independent Private/Parochial Public
School Name Dates of A endance

Address City State/Province Zip/Postal Code

Head of Counselor Telephone

Other schools a end in past three years

School Name City State/Province Zip/Postal

Code

School Name City State/Province Zip/Postal

Code

Signature of Applicant (please sign this a er it has been photocopied) Date

Signature of Parent or Guardian (please sign this a er it has been photocopied) Date
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 PAGE 2 OF 2

SELECTED PROGRAM (mark with an “X”)

_____ Athle c Program _____ Academic Program

Please, complete the following ques ons in case of an Athle c Program:

PHYSICAL INFORMATION

Height ______ Weight______

Allergic________________________________________________________________
Current Treatment_______________________________________________________

ATHLETIC INFORMATION

Experience_____________________________________________________________
______________________________________________________________________
Athlete Strengths________________________________________________________
______________________________________________________________________
Sport/s ________________________________________________________________
Posi on (only if applies)___________________________________________________
Please, select: Dominant Leg RIGHT / LEFT Dominant Arm RIGHT / LEFT

Soccer: Please, indicate one playing posi on for each system of play (only if applies):

Other sport of interest____________________________________________________

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 PAGE 1 OF 1

Admission Applica on APPLICANT QUESTIONNAIRE

Name of Student Current Grade

Current School Applying for Grade

Home address Street/PO Box City

State/Province Country Zip/Postal Code

Instruc ons:

• Complete this form carefully and legibly in your own handwri ng or electronically. Use addi onal
sheets, if necessary.

• You may submit signed photocopies of this form.

• Some schools may ask you to submit addi onal informa on.

1. List and describe your level of interest and par cipa on in school ac vi es (school, volunteer
groups, athle cs, music, etc.). List any awards or honors you received in the past two years. Include
and ac vi es sheet if available.
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PAGE 1 OF 4

Admission Applica on APPLICANT QUESTIONNAIRE

Name of Student:_________________________________________

2. List and describe your level of interest and par cipa on in summer ac vi es. (I.e., camps, jobs,
travel, etc.)

3. List and describe your level of interest and par cipa on in hobbies, ac vi es, and groups not
associated with school. List any awards or honors you received in the past two years.
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4. Why are you applying to boarding school and what do you hope to gain from a ending one?

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Admission Applica on APPLICANT QUESTIONNAIRE

Name of Student:_________________________________________

5. What reading have you enjoyed most in the past year?

6. Describe what is your weakness and what could you do to improve it.
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 7. How would you describe your family and your ROLE in your family? What are you doing together
with your family?

8. What else would you like us to know about you?

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Admission Applica on APPLICANT QUESTIONNAIRE

Name of Student:_________________________________________

9. Please choose one of these statements and then write a 250 – 500 word response to it. Use
addi onal sheets if necessary.

9a. Describe a person you admire or who has in uenced you a great deal.

9b. What makes you the interes ng person that you are? (Be sure to include the quali es you like
best about yourself.)

9c. Explain the impact of an event or ac vity that has created a change in your way of thinking.
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Student’s Signature (please sign this form a er it has been photocopied) Date

PAGE 4 OF 4

Admission Applica on APPLICANT QUESTIONNAIRE

PARENT STATEMENT. Student Characteris cs

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 Research shows that everyone has the 8 character skills below, in di erent amounts, at di erent mes in
their lives. Please select the category you think most re ects the level of skill when thinking about your
child today.
Em Developing Demonstrating No
ergi (This skill is (Clear Basis
ng present and understanding for
(Sta still and use of Judge
rtin developing) this skill) ment
g to

Ini a ve

Intellectual Curiosity

Open-Mindedness

Resilience

Responsibility

Self-Control

Social-Awareness

Teamwork

1. What are the reasons you are considering an independent school for your child?

2. What do you believe your child might contribute to a school community?

3. Are there par cular skills or talents you hope will be cul vated at your child's next school?

4. What experience has posed the biggest academic and/or extracurricular challenge for your
child?

5. How did/has your child responded to that challenge?

6. Is there anything about the sequence of your child's schooling that we should know?

7. Did your child skip or repeat a year?

8. Was your child ever asked to withdraw from any school, suspended, or put on proba on?

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 If you answered yes to any of the ques ons above, please share the experience here.

9. Were there par cular things you or your child learned, gained, or changed as a result of that
experience?

If there is anything you wish to tell us about your child, but that you have not yet had an opportunity to
share, feel free to use the space below to o er your thoughts.

“En nombre de la empresa tratamos la información que nos facilita con el n de prestarles el servicio solicitado, realizar la
facturación del mismo. Los datos proporcionados se conservarán mientras se mantenga la relación comercial o durante los años
necesarios para cumplir con las obligaciones legales. Los datos no se cederán a terceros salvo en casos en que exista una obligación
legal. Usted ene derecho a obtener con rmación sobre si en Come Study USA estamos tratando sus datos personales por tanto
ene derecho a acceder a sus datos personales, rec car los datos inexactos o solicitar su supresión cuando los datos ya no sean
necesarios.

Asimismo solicito su autorización para ofrecerle productos y servicios relacionados con los solicitados y delizarle como cliente:

Si

No
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PAGE 2 OF 2

Admission Applica on ENGLISH TEACHER RECOMMENDATION

To the Applicant:
• Please type or print your name in the space below and then give this form to your current English teacher.

Name of Student (please print) Applicant to Grade

Signature of Student Date

To the Parent/Guardian:

Please read and sign the statement below.

I acknowledge that I waive my right to read the con den al teacher recommenda on and the school report for the
student listed above. (Please have grade reports, a endance records, standardized test scores, and teacher reports/
comments forwarded to each school to which you are applying.)

Name of Parent of Guardian (please print)

Signature of Parent or Guardian Date

To the Teacher:

This form is part of an admission applica on being used by several independent schools throughout the U.S.,
Canada, and abroad. This recommenda on will remain con den al and will not become part of the student’s
permanent record.

Teacher’s Name (please print)

Title School

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 Admission Applica on ENGLISH TEACHER RECOMMENDATION

Name of Student:_________________________________________

How well do you know the student academically?__________________________________ As a person?_________

Are you teaching the student this academic school year? Yes No

If no, what years did you teach the student?___________________________ How large is /was the class?________

What course(s)?_________________________________________________________________________________

Is the student on a block schedule? □ Yes □ No

Is this course part of a tracking system or designated as an honors or accelerated course? □ Yes □ No

Brie y describe your course. It is especially helpful to know what texts are used and if the students are grouped by
ability.

How accurately does the student read and understand what he or she has read?

How well does the student write in comparison with other students whom you have taught? Please be speci c
about areas of strength and weakness.

How well does the student accept advice or cri cism?

What are the rst three words that come to mind to describe this student?

1. 2. 3.
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 PAGE 2 OF 3

Admission Applica on ENGLISH TEACHER RECOMMENDATION

Name of Student:_________________________________________

Please check marks at the points that represent your evalua on of the student in comparison to other students in
his or her age group whom you have taught. If you have no fair basis for judgment, do not hesitate to say so.

One of the
top few I Excellent Good No basis
have ever (top 10% (above Below For
encountered this year) Average) Average Average judgement

Academic poten al

Academic Achievement

Intellectual Curiosity

E ort/Determina on

Ability to Work Independently

Organiza on

Crea vity

Willingness to Take Intellectual Risks

Concern for Others

Honesty/Integrity

Self-esteem

Maturity (rela ve to age)

Responsibility

Respect Accorded by Faculty

Respect Accorded by Peers

Emo onal Stability

Overall Evalua on as a Person

Overall Evalua on as a Student

If the student is rela vely weak or strong in any areas listed above, please elaborate.

Please comment on this student’s character, ci zenship, and contribu ons to your community.

Please add any addi onal informa on that will give us a more complete picture of the student.

Signature Date

Mailing Address
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Email Address Telephone

PAGE 3 OF 3

Admission Applica on PRINCIPAL/HEAD/COUNSELOR RECOMMENDATION

To the Applicant:
• Please type or print your name in the space below and then give this form to your current Principal, Head, or
Counselor.

Name of Student (please print) Applicant to Grade

Signature of Student Date

To the Parent/Guardian:

Please read and sign the statement below.

I acknowledge that I waive my right to read the con den al teacher recommenda on and the school report for the
student listed above. (Please have grade reports, a endance records, standardized test scores, and teacher reports/
comments forwarded to each school to which you are applying.)

Name of Parent of Guardian (please print)

Signature of Parent or Guardian Date

To the Principal/Head/Counselor:

This form is part of an admission applica on being used by several independent schools throughout the U.S.,
Canada, and abroad. This recommenda on will remain con den al and will not become part of the student’s
permanent record.

Teacher’s Name (please print)

Title School

PAGE 1 OF 3
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 Admission Applica on PRINCIPAL/HEAD/COUNSELOR RECOMMENDATION

Name of Student:_________________________________________

How well do you know the student academically?__________________________________ As a person?_________

Please submit these materials with this recommenda on:

□ Recent teacher reports, if any □ Final or mid-semester grades for current term (must be included)
□ Standardized test scores □Grades since 6th grade, if available (for younger children, grades
for all years)
□ A school pro le, if available
In what month does your school year begins? _________________________End?____________________________
School serves grades: _________to _________. Number of students in en re school: ________________
Does your school use a block scheduling system? □ Yes □ No
Please explain your school’s grading system. What is the passing mark?_______________ Honors mark?
____________________
What percentage of your students receive which grades?
Does your school rank? □ Yes □ No
Is your rank □ Approximate □ Exact How many students are in the en re grade?
___________________________________
This candidate ranks _________________out of ______________________ ______________ other students
share this rank.

Are students placed in sec ons according to ability? □ Yes □ No If yes, please tell us in which level the applicant
is placed for each subject.

What are the rst three words that come to mind to describe this student?

1. 2. 3.

If the student’s a endance record is not listed on the transcript, please indicate the number of days he or she has
been absent or tardy each year while at your school.

If the student is not, or has not been, in good academic standing, please explain.
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 Has the student ever been dismissed, suspended, placed on proba on, or received other serious disciplinary
sanc on? □ Yes □ No
Has he or she withdrawn from school voluntarily for an extended period of me for reasons other than health?
□ Yes □ No
If the answer to either or both of these ques ons is yes, please provide a full explana on on a separate piece of
paper.

PAGE 2 OF 3

Admission Applica on PRINCIPAL/HEAD/COUNSELOR RECOMMENDATION

Name of Student:_________________________________________

Please check marks at the points that represent your evalua on of the student in comparison to other students in
his or her age group whom you have taught. If you have no fair basis for judgment, do not hesitate to say so.

One of the
top few I Excellent Good No basis
have ever (top 10% (above Below For
encountered this year) Average) Average Average judgement

Academic poten al

Academic Achievement

Intellectual Curiosity

E ort/Determina on

Ability to Work Independently

Organiza on

Crea vity

Willingness to Take Intellectual Risks

Concern for Others

Honesty/Integrity

Self-esteem

Maturity (rela ve to age)

Responsibility

Respect Accorded by Faculty

Respect Accorded by Peers

Emo onal Stability

Overall Evalua on as a Person

Overall Evalua on as a Student

If the student is rela vely weak or strong in any areas listed above, please elaborate.

Please comment on this student’s character, ci zenship, and contribu ons to your community.

Please add any addi onal informa on that will give us a more complete picture of the student.
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 Thank you for taking your valuable me to complete this evalua on. Your re ec ons are an important part of the
student’s applica on.

Signature Date

Mailing Address

Email Address Telephone

PAGE 3 OF 3

Admission Applica on MATHEMATICS TEACHER RECOMMENDATION

To the Applicant:
• Please type or print your name in the space below and then give this form to your current Mathema cs
teacher.

Name of Student (please print) Applicant to Grade

Signature of Student Date

To the Parent/Guardian:

Please read and sign the statement below.

I acknowledge that I waive my right to read the con den al teacher recommenda on and the school report for the
student listed above. (Please have grade reports, a endance records, standardized test scores, and teacher reports/
comments forwarded to each school to which you are applying.)

Name of Parent of Guardian (please print)

Signature of Parent or Guardian Date

To the Teacher:

This form is part of an admission applica on being used by several independent schools throughout the U.S.,
Canada, and abroad. This recommenda on will remain con den al and will not become part of the student’s
permanent record.
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 Teacher’s Name (please print)

Title School

PAGE 1 OF 3

Admission Applica on MATHEMATICS TEACHER RECOMMENDATION

Name of Student:_________________________________________

How well do you know the student academically?__________________________________ As a person?_________

Are you teaching the student this academic school year? Yes No
If no, what years did you teach the student?___________________________ How large is /was the class?________
What course(s)?_________________________________________________________________________________
Is the student on a block schedule? □ Yes □ No
Brie y describe your course. It is especially helpful to know what texts are used and if the students are grouped by
ability.

Next year what math course would be the most appropriate placement for the student?
__________________________________
Is this course part of a tracking system or designated as an honors or accelerated course? □ Yes □ No

Student’s Mathema cal Background: The courses listed below suggest a sequence typical of the mathema cs
curriculum in many U.S. secondary schools. If your school does not follow this sequence, please a ach your
curriculum. Please check those courses or list others for which the student will have completed by the end of the
current school year.

□ Basic First Year Algebra (does not include extensive study of ra onal expressions, irra onal numbers, and
quadra c equa ons)
□ First Year Algebra (a thorough course which included quadra cs)
□Geometry
□ Second Year Algebra (not including trigonometry)
□ Second Year Algebra (includes numerical trigonometry through the laws of sine and cosine)
□ Pre-Calculus (including analy cal trigonometry)
□ Calculus (an introduc on) □ Calculus (Advanced Placement AB) □ Calculus (Advanced Placement BC)
□ ____________________________________________

Please check marks at the points that represent your evalua on of the student in comparison to other students in
his or her age group whom you have taught. If you have no fair basis for judgment, do not hesitate to say so.
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 One of the
top few I Excellent Good No basis
have ever (top 10% (above Below For
encountered this year) Average) Average Average judgement

Knowledge of the Basic Skills

Accuracy in the Use of Basic Skills

Problem Solving Ability

Reasoning Ability

Understanding of and Apprecia on

for the Underlying Ideas and
Concepts
E ort

Overall Performance

Willingness to Accept the Challenge

of the More Di cult Problems and
Exercises

Command of Mathema cs When

Compared to Other Students Whom
You Have Taught

What are the rst three words that come to mind to describe this student?

1. 2. 3.
PAGE 2 OF 3

Admission Applica on MATHEMATICS TEACHER RECOMMENDATION

Name of Student:_________________________________________

Please check marks at the points that represent your evalua on of the student in comparison to other students in
his or her age group whom you have taught. If you have no fair basis for judgment, do not hesitate to say so.
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 One of the
top few I Excellent Good No basis
have ever (top 10% (above Below For
encountered this year) Average) Average Average judgement

Academic poten al

Academic Achievement

Intellectual Curiosity

E ort/Determina on

Ability to Work Independently

Organiza on

Crea vity

Willingness to Take Intellectual Risks

Concern for Others

Honesty/Integrity

Self-esteem

Maturity (rela ve to age)

Responsibility

Respect Accorded by Faculty

Respect Accorded by Peers

Emo onal Stability

Overall Evalua on as a Person

Overall Evalua on as a Student

If the student is rela vely weak or strong in any areas listed above, please elaborate.

Please comment on this student’s character, ci zenship, and contribu ons to your community.

Please add any addi onal informa on that will give us a more complete picture of the student.

Thank you for taking your valuable me to complete this evalua on. Your re ec ons are an important part of the
student’s applica on.

Signature Date

Mailing Address

Email Address Telephone

PAGE 3 OF 3
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