Admisssions Application - 24'-25'
International Boarding and Day School (Grades 6-12)
Student Name
*
First Name
Middle Initial
Last Name
Date of Birth
*
Please select a month
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Month
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Day
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Year
Age
*
Bording / Day
*
Gender
*
Please Select
Male
Female
N/A
Current Grade
*
Please Select
Kindergarten (K)
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
Applying For Grade
*
Please Select
Kindergarten (K)
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Student E-Mail
Cell Number
Please enter a valid phone number.
Stuedent resides with
*
Mother & Father
Mother Only
Father Only
Guardian
Primary Contact
*
Mother
Father
Guardian
Consultant
Country of Citizenship
*
Please Select
Afghanistan
Albania
Algeria
Andorra
Angola
Antigua & Deps
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bhutan
Bolivia
Bosnia Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Central African Rep
Chad
Chile
China
Colombia
Comoros
Congo
Congo {Democratic Rep}
Costa Rica
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Fiji
Finland
France
Gabon
Gambia
Georgia
Germany
Ghana
Greece
Grenada
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland {Republic}
Israel
Italy
Ivory Coast
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Korea North
Korea South
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Myanmar, {Burma}
Namibia
Nauru
Nepal
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
Norway
Oman
Pakistan
Palau
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Qatar
Romania
Russian Federation
Rwanda
St Kitts & Nevis
St Lucia
Saint Vincent & the Grenadines
Samoa
San Marino
Sao Tome & Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tonga
Trinidad & Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Yemen
Zambia
Zimbabwe
Educational History
Last School Attended (Most Recent)
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
School Website URL:
SSAT Score: (optional)
Please upload your transcript
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Previous Schools Attended:
*
Provide any relevant information regarding prior schools
Parent / Guardian Information
Relationship to Candidate:
*
Full Name
*
First Name
Middle Initial
Last Name
Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Place of Employment
Email
*
Work Phone
Please enter a valid phone number.
Cell Phone
*
Please enter a valid phone number.
Job Title
Educational Consultant (if applicable)
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Company
*
Student Overview
Future Goals & Aspirations
*
Extracurriculars & Activities (Outside of School)
*
Awards & Accomplishments
*
Community Service
*
Social Media Handles
*
Please include all of your digital image links that you want to share with us for consideration of this appliaction
Sports
*
Provide details about any teams please and positions played
Arts / Music
*
List all school participation in the arts including performances
Parent Questions
1. Has the student ever received or will require special education services?
*
Please let us know if you would like the student evaluated for special education services and if so, why.
2. Does the student have an Individualized Education Plan (IEP) or 504 Plan?
*
Please Select
IEP
504 Plan
N/A
If yes, submit a copy of IEP or 504 Plan.
IEP / 504 Plan Document Upload
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5. Student Writing Sample
*
Please tell us why you would like to attend Springfield Commonwealth Academy
5. Languages
*
What is your native language and what other languages do you speak or have you taken and at what level
Program Fee
*
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SCA Application 1
Application fees are paid through the online application and are non-refundable.
$
95.00
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
As the parent / guardian, why do you want the candidate to attend Springfield Commonwealth Academy?
*
Where did you initially hear about SCA?
*
Signature
I confirm that all the information above is true and accurate.
Parent Signature
*
Date
*
-
Year
-
Month
Day
Date
Student Signature
*
Date
*
-
Year
-
Month
Day
Date
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