2020-2021 Holden High School Application

Apply to Holden High School
2020 - 2021 School Year

Thanks for applying to Holden High School! Holden is an open and affirming school. Holden provides a student-centered educational experience that embraces diversity and nurtures students' unique gifts and talents. We do not discriminate based on race, gender, gender identity, gender expression, age, sexual orientation, disability, religion, sexual orientation, national origin, ethnicity, or wardrobe.
Inquiry Process: Visiting Holden in person is a great way to determine if Holden is a good fit for your student. Please call 925-254-0199 or follow the links below to register for one of the following options:
- Visit us online to RSVP for a Small Group Tour conducted during the school day. Holden limits these to no more than three families per group.
- Information Nights are scheduled on Wednesdays and begin at 6pm. Visit us online for upcoming dates.

(2020 - 2021 school year) Application Checklist
Application Checklist
1. Complete and return Application Form.
2. Schedule student for a visit day. Student interviews will be held during the visit day. (Students may visit before submitting an application.)
3. Submit transcripts and most recent report card, current IEP or 504
  plan, and/or learning assessment. (If applicable)
4. Fill out and submit a medical release form (if applicable)
  Completed Teacher Recommendation Form. This form should be emailed to kristinl@holdenhigh.org or mailed directly to Holden High School Admissions.
5. Submit a writing sample from current school year (essay, research paper, creative writing piece). On the writing sample, please include the nature of the assignment. ( If applying for Elective Class Option Program, no writing sample is needed. )
6. Download, fill in, and upload a Medical Release Form.
7. Download, fill in, and upload a Teacher Recommendation Form.
8. Submit application fee of $87.
9. Optional : schedule student for a visit week. The non-refundable fee for avisit week is $275.
Note: Sometimes the admissions committee requests additional interviews or forms to be completed.

Parent / Guardian Contact Information
Guardian #1 Name:

First Name Last Name
Guardian #1 Email
example@example.com
Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Guardian #1 Phone Number

Area Code Phone Number
Guardian #1 Occupation:
Guardian #1 Employer
Guardian #2 Name:

First Name Last Name
Guardian #2 Email
example@example.com
Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Guardian #2 Phone Number

Area Code Phone Number
Guardian #2 Occupation:
Guardian #2 Employer
IMPORTANT:

SCROLL DOWN TO THE BOTTOM OF THIS APPLICATION AND SELECT "SAVE" BEFORE BEGINNING THE NEXT SECTION. (SAVE BUTTON LOCATED IN THE "APPLICATION FEE" TAB)

Prospective Parents/Guardian Questionnaire
Why are you interested in having your teen attend Holden High School?
Please briefly describe your teen.
Describe your teen’s strengths and challenges in the following areas: A. Academic B. Social/Emotional C. Creative
What interests does your teen have? Do they participate in any after school activities? If so, what?
What are your teen’s responsibilities at home? Please explain.
Are there any learning or health issues about which we should be aware?
What educational (classroom or assignment based) accommodations have been helpful in the past?
If your teen has received or is receiving therapy, please explain the reason for this:
Additional paperwork may be required
Does your teen have a history of violence in or out of school?

Yes No
If yes, please explain:
Has your teen ever received severe disciplinary censure at school or from the community?

Yes No
If yes, please explain:
IMPORTANT:

SCROLL DOWN TO THE BOTTOM OF THIS APPLICATION AND SELECT "SAVE" BEFORE BEGINNING THE NEXT SECTION. (SAVE BUTTON LOCATED IN THE "APPLICATION FEE" TAB)

Files to Upload
Please upload the following with this application:
Transcripts / Most Recent Report Card:

Browse Files
Please upload your students transcripts and most recent report card. Cancel of
IEP/504 Plan and Learning Assessments

Browse Files
Please upload your students current IEP or 504 plan and learning assessments, and a medical release (if applicable) Cancel of
Student Writing Sample (Current School Year)

Browse Files
Please upload a student writing sample from current school year (essay, research paper, creative writing piece). On the writing sample, please include the nature of the assignment.(If applying for the Elective Class Option Program, no writing sample needed.) Cancel of
IMPORTANT:

SCROLL DOWN TO THE BOTTOM OF THIS APPLICATION AND SELECT "SAVE" BEFORE BEGINNING THE NEXT SECTION. (SAVE BUTTON LOCATED IN THE "APPLICATION FEE" TAB)
Note: Holden High School may request additional information before the application is complete.

Confidential Teacher Recommendation Form
Confidential Teacher Recommendation Form

Directions:
1. Share the "Confidential Teacher Recommendation Form" PDF with your student's teacher.
2. Instruct your child's teacher to email the completed form to kristinl@holdenhigh.org

Medical Release Form
Medical Release Form

Please complete this form ONLY if your child is currently in therapy and/or has recently been in a therapeutic program.

Directions:

1.) Click here to download Medical Release Form

2.) Complete all form sections

3.) Upload completed Medical Release Form
Upload your completed Medical Release Form

Browse Files

Cancel of
IMPORTANT:

SCROLL DOWN TO THE BOTTOM OF THIS APPLICATION AND SELECT "SAVE" BEFORE BEGINNING THE NEXT SECTION. (SAVE BUTTON LOCATED IN THE "APPLICATION FEE" TAB)

Prospective Student Questionnaire
This section should be completed by the prospective student.
Why are you interested in applying to Holden?
From what you have learned by visiting the school, or what you have read on the website, briefly describe Holden High School.
Describe one thing you are good at and one thing that is hard for you in the following areas: A. Academic B. Social/Personal C. Creative
What do you do for fun? What kinds of things interest you?
What current event(s) interest you?
What personal qualities would you bring to our school community?
What are two goals you would like to accomplish this school year (academic, social, personal and/or creative)?
Have the student responses been dictated or typed by someone other than the prospective student?

Yes No

Application Fee
All prospective families must complete this application in its entirety AND submit the $87 application fee.

(* The application fee may be submitted online using the link provided or with a check payable to "Holden High School" mailed to 10 Irwin Way, Orinda, CA 94563, listing Application Fee in the memo field)
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