• Parent 1 Information

  • Format: (000) 000-0000.
  • Marital Status*
  • Financially Responsible Party*
  • Step Up for Students Scholarship status:*
  • Parent 2 Information

  • Format: (000) 000-0000.
  • Student Information

  • Format: (000) 000-0000.
  • Anticipated Start Date*
     - -
  • Birthday*
     - -
  • Program
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  • Current School Information

  • Will your student require an F-1 Visa?
  • Birthday
     - -
  • Gender
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Passport Expiration Date
     - -
  • Questionaire

  • Has Student ever repeated a grade?*
  • Has Student ever skipped a grade?*
  • Has the Student ever been suspended, expelled, or asked to withdraw?*
  • Support Questionaire

  • Since students coming to Score Academy have a wide range of learning styles and varying degrees of emotional development, we sometimes need more information in order to support them in their education. In order for us to best serve your student it is important that we receive medical, psychiatric, and/or psychological information that is pertinent to your student’s ability to learn and function successfully at Score Academy.

    Please know that any information that you share with us is confidential, used to review the appropriate supports for your student, and not as a determining factor for the admission decision. Your student’s application will be complete for review after the questionnaire and corresponding materials are received.

  • Has your student been identified with a learning difference or disability?*
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  • Has your student ever received tutoring or remedial instruction to assist learning or academic performance, whether inside or outside the school environments?*
  • Is your student currently taking any medication(s)?*
  • Has your student experienced any problems related to drug or alcohol use?*
  • Has your student received counseling or assistance for symptoms of depression or anxiety at any time?*
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  • Has your student ever received counseling or assistance for any emotional behavioral, mental health, or social problems?*
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  • Should be Empty: