The Academy at Old Cockrill

The Academy at Old Cockrill - Application
Please complete all areas of the application that apply to you. Certain fields are required. When finished, click "Preview" to review your application before submission. From the "Preview" screen, you will be able to submit the application.

The online application process is:
- Fill out and submit your application. Be sure to answer all of the questions as thoroughly as you can.
- The principal and school counselor will review your application, transcripts and discipline reports, and you will then receive a phone call regarding your application.
Date of Application (today's date)

MonthDayYear
Date
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Phone

Area CodePhone Number
Cell Phone

Area CodePhone Number
Work Phone

Area CodePhone Number
Place of Work
Date of Birth

MonthDayYear
Date
Age
E-mail
Parent / Guardian Name

First NameLast Name
Parent / Guardian Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent / Guardian Phone Number

Area CodePhone Number
Last School Attended
City and State of Last School Attended

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Do you require an interpreter?
If yes, what language is needed.
Are you currently enrolled in school?
If you are not enrolled in school, please explain why.
Why are you applying to the Academy at Old Cockrill?
What qualities do you want in a teacher?
Do you have access to a computer and internet connection?
Where do you have access? Please check all that apply.
Do you know anyone currently enrolled at the Academy at Old Cockrill, or someone who graduated from the Academy? If yes, who?
Has anyone in your immediate family attended college?
Please use the space below to write about yourself and tell why you think the Academy at Old Cockrill would be a good school for you.

Federal regulations require that all students enrollling in a public school answer the following questions. These questions provide us with valuable information on how to best serve you.

Do you speak a language other than English?
Which language(s) do you speak?
What language did you first learn to speak?
What language do you speak most often outside of school?
What language do people usually speak in your home?
Were you born in the United States?
In what country were you born?
What date did you enter the United States?
We have found that our most successful students are the students who have completed the application themselves. In good faith, we are presuming the student named above is the one who has completed the application. Filling out the application for someone else may result in the applicant not being accepted.
Please check one.
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The Academy at Old Cockrill - Application