Apply to Raphael Academy: Early Childhood & Early Grades Apply to Raphael Academy: Early Childhood & Early Grades Step 1 of 4 25% Applicant's basic informationSchool year applying for*2020–20212021–20222022–2023Grade applying for*Kindergarten1st2nd3rd4thPlease upload a photo of the child.*Child's name* First Middle Last Date of birth* Date Format: MM slash DD slash YYYY Age*Gender*Residential address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Mailing address, if different from residential address Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Alternate phoneCurrent nursery/school program*Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Grades attended*Parent/Guardian Contact InformationParent/Guardian 1 Name* First Last Relationship to child*Address, if different from child's Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home phone*Mobile phone*Work/alternate phoneEmail* OccupationLocation of workI have another parent/guardian to add*YesNoParent/Guardian 2 Name* First Last Relationship to child*Address, if different from child's Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home phone*Mobile phone*Work/alternate phoneEmail* OccupationLocation of workGrandparent Contact InfoGrandparent 1 Name First Last Address Street Address City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Email PhoneGrandparent 2 Name First Last Address Street Address City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Email PhoneApplicant InformationHeightWeightHair colorEye colorReligious affiliationPrimary language spoken at home*Emergency Contact InfoEmergency Contact 1 Name* First Last Relationship to child*Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Emergency Contact 2 Name* First Last Relationship to child*Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone* Page TitleThank you for answering the following questions to the best of your knowledge. This information, which will be kept strictly confidential, will help us to understand your child.PregnancyDo you know of any hereditary or congenital diseases in the family on either side?*Note any of the following conditions: genetic syndromes, autism, epilepsy, mental or nervous diseases, malformations, deafness or other serious diseases.Describe any bleeding (during pregnancy), premature labor, infections, accidents or medical complications.*BirthLength of pregnancy*Duration of labor*Describe the birth.*Easy or difficult, instruments used, anesthesia, C-section, etc.Describe the neonatal course.*For example, neonatal ICU, care, treatment for jaundice, antibiotics, spinal tap, oxygen, etc.Did the baby require special treatment to assist breathing injections, oxygen, etc.?*YesNoBirth weight*Any other comments on your child’s birth.InfancyHow was your baby fed during the first year of life? Describe any complications.*Did the infant show affection in the usual way? Was he/she quiet or restless? Was he/she a “happy baby”?*Were there any disturbances of digestion, recurrent vomiting, or colic? Please describe.*Was there any unusual sleep pattern? Please describe.*Developmental MilestonesAt what age was your child exhibiting the following behaviors?First smile*Reaching out for things*Teething*Sitting unaided*Walking unaided*Crawling*First word said*What was it?*Speaking in sentences*Any other comments relating to infancy.Were there periods of regression, loss of speech, etc.?*Did your child have tics, repetitive movement patterns, fixations or self-stimulatory behavior?*When and why did you become concerned that your child was not developing normally? What did you do about it?*What is your child’s diagnosis? When was it first made? Has it changed over the years?* Childhood to PresentThank you for answering the following questions to the best of your knowledge. This information, which will be kept strictly confidential, will help us to understand your child.CommunicationDescribe your child’s ability to speak and/or other means of communication.*What other means are used?*Sign, gesture, assistive device, etc.BehaviorHas your child received special behavioral treatment or therapy, such as wrap-around services, or ABA (Applied Behavioral Analysis?)*YesNoDid you find ABA helpful? Give details.*Where were the services received?*Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code May we contact them?*YesNoDates of service (approximate)*Describe any self-stimulatory behaviors and/or aggressive behaviors.*Rocking, head-banging, and/or verbal or physical aggression, etc.Describe any behavior issues.*Running away, hiding objects, bad habits, obsessions and/or compulsions, destructiveness, self-abusive, aggression (verbally/physically), etc.When do these behaviors usually occur (what conditions/situations)?*What do you do to discipline your child?*How does she/he react to discipline?*Does your child have a “behavior intervention plan?”*YesNoAre you willing to work with the school staff to review and modify if necessary?*YesNoDescribe your child’s self care and toileting habits.*Teeth brushing, washing, toilet trained, etc.How many hours per day does your child watch TV, movies, or play computer/video games?*Are you willing to work with staff to make adjustments to media exposure, if necessary?*YesNoEating HabitsDescribe eating habits.*Use of utensils, how your child relates to food/meal times, etc.What does your child usually eat for...Breakfast?*Lunch?*Supper?*Snacks?*How many snacks a day?*Additional comments.Is your child on a special diet? What is the reason for the diet? Please be specific.*Sleeping HabitsDescribe sleeping habits.*Bedtime, how long, how deeply, etc.What does your child do if he/she awakens in the night?*Cry, make noise(s), wander, etc.Medical Diagnosis/TreatmentWhat illnesses or childhood diseases has your child had, and at what age?*Click the plus sign at the right to add additional rows.Illness or diseaseAge Describe any falls or accidents and at what age they occurred.*Click the plus sign at the right to add additional rows.Fall or accidentAge Has your child had any seizures?*YesNoDescribe type, duration, and frequency. Did they recur at particular times?*List all current medications and purposes (seizures, anxiety, behavior, etc.), dosages and when started (approximately).Click the plus sign at the right to add additional rows.DrugDosagePurposeDate Started List all previous medications and purposes (seizures, anxiety, behavior, etc.), dosages and when stopped (approximately).Click the plus sign at the right to add additional rows.DrugDosageWhy was it discontinued?Date StartedDate Stopped Has your child been prescribed or given any unconventional treatments?*Special diets, supplements, vitamins, homeopathy, etc.?YesNoPlease describe. Have they been effective?*Admission or outpatient attendance at hospitalClick the plus sign at the right to add additional rows.Date of admissionReason for admission or attendance SocialHow would you describe your child as a person?*Strengths and needs*What does your child like to do?*Hobbies, interests, etc.What kinds of things scare or worry your child?*Does your child have a current IEP?*YesNoPlease attach the most recent copy.*Check any of the following areas of concern regarding your child.* Bedwetting Wetting during the day Thumb sucking Stammering or stuttering High strung or easily upset Too restless Shy Sad or sulky Feelings easily hurt Wanting too much attention Wanting too much comfort/support from parent Daydreaming Sleep issues Nightmares Temper tantrums Contrary or stubborn Disobedient Lying Selfish in sharing Jealous of brothers & sisters Fighting with other children Purposely destroys things Feeding Toilet issues Other None of the above Elaborate further if needed.How many other members of the family live in the same house as the child (siblings, grandparents, aunts/uncles, etc.)? What is each member’s relationship to the child? Please include the ages of any siblings.*Click the plus sign at the right to add additional rows.Member's relationship to the childAge, if sibling Are there any family social/economic issues, such as problems with housing, employment, food, etc. (describe)?*Who looks after the child...*Most of the time?During the day?In the evening?EducationWhy are you considering a change of school for your child at this time?*What is the current ratio of staff/child at your child’s current/previous school/daycare?*What was your child’s support level? Why?*Independent, part-time aid, full-time aid, etc.Does your child presently receive related services?*YesNoList types and frequency.*e.g. Speech, 1x/week, 30 minutesType of serviceFrequencyDuration How does your child relate to going to school/education?*Does your child enjoy singing, dancing, rhyming and storytelling?*What does your child like best about school?*What does your child like least about school?*Is your child currently or has your child recently been under the supervision of a psychologist, psychiatrist, counselor, or other mental health professional?*YesNoPlease describe the following for each mental health professional your child has seen.Click the plus sign at the right to add additional rows.NameAddressReason seenApproximate period of attendanceAdvice given to you Additional commentsHas your child undergone any psychological or intelligence tests?*YesNoPlease attach a copy of all evaluations.* Drop files here or Has your child had any private tutoring?*YesNoWhen? For what?*Is your child registered with the local human services, social services, MD/IDD agency to receive services?*YesNoName of Supports Coordinator/Case Manager/Social Worker*Name of agency*Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Email* If your child is accepted, would you continue or plan any other programs after or during school hours?*YesNoPlease describe.*Parent InvolvementHow would you like to, or imagine you would, be involved in your child’s education (e.g. parent teacher evenings, parent workshops, parent groups, volunteering for events, etc.)? Specify:*Final NotesHow did you learn about Raphael Academy?*Do you have any remarks you wish to add? Please feel free to add any more information on any of the previous questions or any information you feel is important that was not asked for. Enrollment Responsibility & ProcessRaphael Academy is a sponsored project of Waldorf Education Association of New Orleans. Waldorf Education Association of New Orleans is a not for profit 501(c)(3). Complete financial responsibility for student’s initial and continued enrollment, until otherwise changed in writing, will be assumed by:Name* First Last Relationship to child*Name First Last Relationship to childPlease complete and submit the Authorization for Release of Student Records to the student’s previous school/program. Current school records will need to be obtained by Raphael Academy to a final decision for student’s acceptance.Upload your completed Authorization for Release of Student Records.*Application FeePlease enter the name, confirmation email, and billing address that should be associated with your application fee payment below. Once you submit this application, you'll be redirected to our PayPal online payment portal, where you may complete your non-refundable $50.00 application fee payment.Application Fee* Price: $50.00 Name* First Last Confirmation Email* Billing Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country SignaturesOnce the above items are received, you will be contacted by phone to schedule an Entrance Interview for you and your child. Applicants are considered for admission without regard to race, color, creed, or national or ethnic origin.Name of parent/guardian 1* First Last How would you like to provide your signature?*I would like to digitally sign my name.I would like to type my signature.Parent/guardian 1 signature*Use the box below to sign your name. Click the refresh icon at the bottom right to clear the box.Parent/guardian 1 signature*Type your full name. This will serve as your digital signature.Name of parent/guardian 2 First Last How would you like to provide your signature?I would like to digitally sign my name.I would like to type my signature.Parent/guardian 2 signatureUse the box below to sign your name. Click the refresh icon at the bottom right to clear the box.Parent/guardian 2 signatureType your full name. This will serve as your digital signature.CAPTCHANameThis field is for validation purposes and should be left unchanged.
