Urban Achievers School Parent/Guardian Information Form

Parent/Guardian Information

2025-2026 Academic Year
Urban Achievers Admissions Policy Statement

In reviewing applications the admissions committee considers each applicant's unique strengths, experiences, and aspirations with the aim of ensuring that our diverse student body reflects a broad spectrum of talents and perspectives. UA's primary aim is to serve young men from opportunity-challenged communities and at least 90% of spots will be reserved for these students. However, inquiries are welcome from all and applicants from families with greater resources will also be considered.

Urban Achievers School does not discriminate on the basis of race, color, national origin, ethnic origin, religion, ancestry, or sexual orientation in administration of its admission policies, educational policies, and athletic and other school-administered programs.

Please contact Sasha Eskelund with any questions about the application process: sasha.eskelund@urbanachievers.org.
Application Requirements

1. Student application form to be completed and submitted by student.

2. Parent/guardian information form to be completed and submitted by a parent or guardian.

3. Middle-school transcripts (sixth to eighth grade) to be submitted by current and past schools.

4. MCAS, MAP, and/or other standardized testing results submitted by schools.

5. Recommendation letters: we require one recommendation from a humanities teacher and one from a STEM teacher. We accept an optional third recommendation letter from another person in the student's life. This could be a coach or someone else who knows the student well. Recommendation forms will be emailed to the family upon receipt of the online application.

6. Most recent W-2s and tax returns to be submitted by parents/guardians.

7. Home Visit: Urban Achievers administrators will arrange with the family to visit the home. During this visit, UA will conduct an interview with the student and discuss the School with a parent/guardian.
Admissions Timeline
- Applications will be accepted online beginning November 15, 2024.
- Student interviews and conversations with parents/guardians are an important part of the application process. These will take place following receipt of a completed application.
- No applications will be considered after April 1, 2025.
- Applications will be reviewed on a rolling basis.
- Students and parents/guardians will be notified of the status of their application no later than May 1, 2025.
Family Commitment

We're not just a school, we're a community. With this in mind, all students, parents, and guardians will be expected to support and uplift the community. Our tuition-free model relies on the participation of all, and families are expected to support the School with time and resources according to their circumstances. Students are expected to support the School by adhering to all School rules, modeling kindness and respect for others in and out of the classroom, and making commitments to athletics, schoolwork, and service.
Family Information
Student Name *

First NameMiddle NameLast Name
Student Birth Date*
Student's Current School*
Student's Current Grade*
Is the student male? *
Urban Achievers looks forward to opening a sister school for girls with a passion for sports and commitment to self and community. If you'd like to be kept up to date about the progress toward a girls' school, please enter your email address below.
example@example.com
Student Address *

Street Address

Street Address Line 2

CityState

Zip Code
Student resides with (name, relationship) *
Names and Relationships (Ex: Nina Simone, Mother)
Primary Language Spoken in the Home. *
Additional language(s) spoken in the home.
Race:

American Indian or Alaska NativeAsianBlack or African AmericanNative American or Other Pacific IslanderWhiteOther
Ethnicity:

Hispanic or LatinoNot Hispanic or Latino
How did you hear about Urban Achievers School?
Siblings
Please list the names, ages, and schools (if applicable) of other children in the household:
Do you have other children who currently take part in Urban Achievers Summer and Afterschool Program or who have taken part in the past?

YesNo
Please enter their names below.
Parent/Guardian Information

Parent/Guardian 1
Parent/Guardian 1 Name*

First NameLast Name
Relationship to student*
Parent/Guardian 1 Address*

Street Address

Street Address Line 2

CityState

Zip Code
Parent/Guardian 1 Phone Number*
Parent/Guardian 1 Email*
example@example.com
Employer Name.
Occupation.
Position/Title.
Work Phone.
What is the highest level of education completed by Parent/Guardian 1?

Middle SchoolHigh SchoolSome collegeCollege DegreeGraduate DegreeOther
Parent/Guardian Information

Parent/Guardian 2
Parent/Guardian 2 Name

First NameLast Name
Parent/Guardian 2 Relationship to Student
Parent/Guardian 2 Address

Street Address

Street Address Line 2

CityState

Zip Code
Parent/Guardian 2 Phone Number
Parent/Guardian 2 Email
example@example.com
Employer.
Occupation.
Position/Title.
Work phone
What is the highest level of education completed by Parent/Guardian 2?

Middle SchoolHigh SchoolSome collegeCollege DegreeGraduate DegreeOther
IMPORTANT: An accurate email and phone number are essential for receiving communication in regard to the application process. Please verify that you entered a correct email and phone number above.
Parent/Guardian Questions

Help us to get to know your son and your family.
What are your son's greatest strengths?
What are his main challenges?
What do you hope your son will gain by attending Urban Achievers School?
Urban Achievers School is a tuition-free independent school. To help support its mission we ask all families to participate in the life of the School by contributing time and resources according to their ability. If your son attends the School, how will your family be prepared to contribute in the 2025-2026 academic year?
PARENT/GUARDIAN AGREEMENT OF SUPPORT
Parent/Guardian, please read each statement below and check the box to signify your understanding and agreement.

Agreement 1 - I will ensure my child arrives at school on time and remains until dismissal from school, daily.

Agreement 2 - I will participate in the education of my child and attend parent conferences when requested.

Agreement 3 - I will communicate with the school any problems that could affect my child’s performance or behavior.

Agreement 4 - I will support the school code of conduct by ensuring that my child is in dress code; that my child comes prepared with school materials (binder, paper, pens, pencils, backpack, etc.); and that my child complies with the no-phones policy during school hours.

Agreement 5 - I understand that if my child does not meet the requirements of Urban Achievers School, the School may request meetings with me and/or meetings with me and my child and that additional supports may be put in place. If these measures do not result in my child's meeting the requirements, further disciplinary measures may be called for and, in cases where no progress is made, my child may be asked to leave the School.

Agreement 6 - I understand that if my child is accepted to Urban Achievers School, our family will be required to participate in and contribute to the life of the School.
- I certify that the information provided is complete and understand that the submission of false information is grounds for denial of the application and/or withdrawal of admission.
- I understand that Urban Achievers School expects a high standard of conduct and academic performance for its students, and if accepted for admission to the school, my child and I will abide by all rules and regulations set forth by both the school and participating organizations.
Application for Admission Verification

Please read each statement below and sign to signify your understanding and agreement.
Parent/Guardian Signature*

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Parent/Guardian Information

Family Information

Siblings

Parent/Guardian Information

Parent/Guardian Information

Parent/Guardian Questions

Application for Admission Verification