Smart Schools International Enrollment Form (Haven)

School Information
Haven Christian School

Address: 32, Yangjimaeul 4-ro, Gwacheon-si, Gyeonggi-do, Republic of Korea, 13813 | Phone: 82-70-4603-6138
School Contact: Shawn Shim

Email Address: shawn.shim@haven.or.kr
Student Information
Student First Name*
Student Last Name*
Preferred Name*
Birth Date*

MonthDayYear
Current Age*
Gender*

MaleFemale
E-mail*
Current grade in school or last grade completed?*
What is the preferred communication method?*

EmailVirtual Meeting
What is the primary language spoken at home?*
Racial/Ethnic Background*

WhiteBlackHispanicAmerican IndianAsianOther
Does the student speak English?*

YESNO
Course Information
Initially, students can request up to 4 courses to be assigned. To review our course options, please visit: www.smartschools.us/catalog
Course Request 1*
Course Request 2
Course Request 3
Course Request 4
Do you want courses assigned consecutively or concurrently?*

Consecutive (one course at a time, one after another)Concurrent (multiple courses at a time)
Parent/Guardian Information (if student is under 18 years old.
Parent Name

First NameLast Name
Parent Gender*

MaleFemale
Parent E-mail
Informed Consent and Acknowledgement

No student will be considered for enrollment until all necessary documentation is received and student eligibility is verified. Misrepresentation or omission of facts on this application may result in denial or nullification of enrollment.

Student also agrees that he/she will meet the contact requirements set forth by mentor/teacher/learning plan. Communication between the student and mentor/teachers/staff is imperative to the student's success.

Academic Integrity Policy

I will do my own work.

I am aware that all core subjects (English, Math, Social Studies and Science) final exams will be proctored.

I will not copy another person’s work, in whole or in part, and submit as my own.

I will not consult unauthorized material or information during tests unless my teacher gives me permission.

I will not plagiarize.

I will not copy text, graphics, mathematics solutions, artistic layouts or presentation, or any ideas in any form from another source without proper citation.

I will not communicate exam information or answers during or following an exam.

I will not provide unwarranted access to materials or information so that credit may be wrongly claimed by others.

I will not turn in an original paper or project for more than one different class assignment.

I will not, in laboratory situations, falsify or fabricate data or observations, including computer output.

By checking the box below I indicate that the information contained in this application is true. I also understand that my student is not enrolled in Smart Schools until such has been confirmed by an authorized member of Smart Schools.

No student will be considered for enrollment until all necessary documentation is received and student eligibility is verified. Misrepresentation or omission of facts on this application may result in denial or nullification of enrollment.
By checking the box below I indicate that the information contained in this application is true. I also understand that my student is not enrolled in Graduation Solutions until such has been confirmed by an authorized member of Graduations Solutions.
Choose one*

I agreeI disagree
Media Release

I, the undersigned, do hereby grant or deny permission to Smart Schools to use the image of myself/my child as marked by my selection below. Such use includes the display, distribution, publication, transmission, or otherwise use of photographs, images, and/or video taken of my child for use in materials that include, but may not be limited to, printed materials, videos and digital images such as those on our website.

No student will be considered for enrollment until all necessary documentation is received and student eligibility is verified. Misrepresentation or omission of facts on this application may result in denial or nullification of enrollment.
By checking the box below I indicate that the information contained in this application is true. I also understand that my student is not enrolled in Graduation Solutions until such has been confirmed by an authorized member of Graduations Solutions.
Choose one*

Grant unrestricted permission to use my/my child's imageDeny permission to use my/my child's image at all
Confirmation and Payment Policy

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.

REFERRING SCHOOL WILL BE BILLED FOR ENROLLMENT AND COURSES. NO REFUNDS AVAILABLE.
Parent/Student over 18 Signature*
Comments
Should be Empty:

School Information

Haven Christian School

School Contact: Shawn Shim

Student Information

Course Information