Mount Academy Application Form

Thank you for your interest!

Please complete this form to begin your student's application for admission.
Student Information
I am interested in enrollment beginning in September:*

2026202720282029 or later
What grade will the student be in the year selected above?*

9th10th11th12th
Admission Type

Day StudentBoarding Student
Student's Full Name*

First NameLast Name
Date of Birth*

MonthDayYear
Gender*

MaleFemaleOther
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Parent/Guardian Information
Parent/Guardian 1
Parent/Guardian 1 Full Name*

First NameLast Name
Relationship to Student*
Does Parent/Guardian 1 currently live with the student?*
Email Address*
example@example.com
Phone Number*
Please enter a valid phone number.
Parent/Guardian 2
Parent/Guardian 2 Full Name*

First NameLast Name
Relationship to Student*
Does Parent/Guardian 2 currently live with the student?*
Email Address*
example@example.com
Phone Number*
Please enter a valid phone number.
Current School Information
Name of Current School*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Academics
Please upload a copy of the student's most recent transcript*

Cancelof
Has the student ever repeated a grade?*

YesNo
If yes, please provide a brief explanation.*
Has the student ever skipped a grade?*

YesNo
If yes, please explain.*
Has the student ever had an IEP, 504 Plan, or been eligible for special education services?*

YesNo
If yes, please upload the most recent report, plan, or assessment.*

Cancelof
How did you hear about Mount Academy?*
Please list the student's interests, hobbies, etc.*
What else would you like us to know about your family and/or student?*
Schedule a Shadow Day for your Student
- A shadow day is a requirement to be considered for enrollment in Mount Academy.
- Shadow days are from 7:45 am to 2:30 pm; the family provides transportation.
- Mount Academy requires a copy of your child's most recent physical exam at least one week prior to the shadow day.
Please choose 3 dates. We will contact you to confirm and to provide additional information.
Shadow day option 1*

MonthDayYear
Shadow day option 2*

MonthDayYear
Shadow day option 3*

MonthDayYear
Should be Empty:

Thank you for your interest!

Student Information

Parent/Guardian Information

Parent/Guardian 1

Parent/Guardian 2

Current School Information

Academics

Schedule a Shadow Day for your Student