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Admissions Application

APPLICATION FOR ADMISSION TO MORGAN PARK ACADEMY

It is the policy of Morgan Park Academy not to discriminate on the basis of race, sex, color, religion, national origin, ancestry, or physical or mental disabilities unrelated to the ability to work or enjoy the benefits of the school's programs, facilities, or services. All persons are encouraged to apply.

	Applicant name (first)*

	(middle)

	(last)*

	Application to grade:*

	For the Academic Year:*

Gender*

	Male
	Female

	Home Address*

	City*

	State*

	Zip Code*

	Telephone Number (please include area code without dashes or spaces between numbers)*

	Date of Birth (format: 00-00-0000)*

	Applicant resides with*

	Person responsible for applicant's payments (not required if same as above)*

	Street Address

	City

	State

	Zip Code

Marital Status of Parents*

	Married
	Divorced
	Separated
	Widow(er)
	Single
	Other:

	Title*

	Father's Full Name *

	Employer*

	Occupation or Title*

	Work Address

	Work Phone

	Street Address (if different from Applicant's address)

	City/State/Zip Code

	Phone Number

	Alternate Phone Number

	Email Address*

	Father's most recent education completed.*

	Title

	Mother's Full Name *

	Employer*

	Occupation or Title*

	Work Address

	Work Phone

	Home Address (if different from Applicant's address)

	City/State/Zip Code

	Home Phone

	Email Address*

	Mother's most recent education completed.*

Professional Affiliations*

	Applicant's Present School*

	School Street Address*

	City/State/Zip Code*

	School Phone Number*

	School Contact Person*

	Current Grade*

Other Children in Family (Please Include Name and Birth Date)

What talents or strong interests does your child exhibit? (e.g. fine or performing arts, athletics, computers, etc.)?*

Has your child ever been accelerated or held back in school? *

	Yes
	No

	If you answered yes to the previous question please describe the circumstances.

Has your child had previous academic problems which require tutoring or remedial help?*

	Yes
	No

	If you answered yes to the previous question, in what content areas and for how long?

Does your child receive medical treatment for allergies or any chronic condition?*

	Yes
	No

	If you answered yes to the previous question, please explain.

Are there limitations on the child's participation in athletics?*

	Yes
	No

	If you answered yes to the previous question, please explain.

Has your child undergone any diagnostic or evaluative testing for learning differences or psychological/psychiatric concerns, either through school or outside of school?*

	Yes
	No

If you answered yes to the previous question, what was the reason for testing? (Please also include the name of the school or agency that administered it, and the date of the test.)

Was your child asked not to return to a previous school?*

	Yes
	No

	If you answered yes to the previous question, please explain.

	Is your child acquainted with any children at Morgan Park Academy?*

	Based on the observations during your visits and/or from the information provided to you, what inspired you to apply?*

	What do you feel your role is in your child's education?*

Essay Questions Please respond thoughtfully to each essay question, numbering your responses 1 - 5. "A family of learners" is a running theme at Morgan Park Academy. When a student enrolls at the Academy, that child's family becomes part of the Academy family and enters an educational partnership. We foster a mutual exchange of ideas, experiences, talents, and learning. As such, it is crucial to gain in-depth insight of your child. We believe each child is unique and has individual abilities and stages of development, as well as specific personalities, learning styles, temperaments, and experiences. Please help us better understand your child by painting a picture of your child in words, specifically:

	Essay Question 1: What are your child's strengths (academic, social, and emotional)?*

	Essay Question 2: How does your child cope with transitions?*

	Essay Question 3: How do you help your child cope with frustrations and challenges?*

	Essay Question 4: What are your expectations of the school?*

	Essay Question 5: Please describe how your child can contribute to the Morgan Park Academy community:*

	How did you learn about the Academy?*

	If parents live at separate addresses, please indicate who should receive correspondence

	Which language(s) is/are most commonly spoken at home?*

Please check the area(s) your child is most interested in

	Visual and Performing Arts
	Math/Science programs
	Creative Writing
	Sports

Family Income Level*

	$0 - $50,000
	$50,000 - $100,000
	$100,000 - $150,000
	$150,000 +

Please select: *Optional

I've attended an:

	Open House
	Tour
	Coffee
	Other:

Checklist*

	All questions in this application have been answered accurately and completely
	A signed record release accompanies this application
	A nonrefundable application fee of $50 accompanies this application

	Application Signature (provide the name of parent or guardian and the date) in the space below*

	I hereby give permission for (provide child's name in space below) to participate in all Morgan Park Academy activities during his/her visit. Activities include, but are not limited to, physical education, recess, art, music, and classroom activities. I know of no reason why my child should be limited in his/her participation in any school activity or program.*

	Permission Signature (Provide name of parent or guardian along with the date in space below) *

There is a $50 application submission fee. Please indicate payment option below. *Note- With Cash and Check options application will not be processed until payment is received.*

	Cash
	Check
	Credit Card

	Please enter amount to be charged on credit card here. If paying by cash or check please enter 0.*

Cardholder’s Name:
Credit Card Type:
Card Number:
Expiration Date:

Download our School Record Release form and print and submit to Morgan Park Academy.

Please Note: Questions marked with an asterisk (*) are required.

CALENDAR

September 2010
- 09-06 Labor Day
- 09-07 Opening Day Coffee
- 09-07 Opening Day of School
- 09-12 Back to School Family Picnic 1:00 PM to 4:00 PMSunday, September 12 from 1:00-4:00 p.m. in the Jones Bowl