2008-'09 Application for New Students
This application must be filled out by the applying student. Parents may supply information the student lacks. If you need more space than is allotted, feel free to use a separate sheet when necessary.
Student Name: ___________________________________________________
(Last) (First)
Date of Birth: _______________________Grade (`08-'09) _________________
Address: ________________________________________________________
(Street) (City) (State) (Zip)
Telephone: _________________________Parent E-mail___________________
Father: _____________________________Cell/Work Number:______________
Mother:_____________________________Cell/Work Number:______________
Fax # (Home)________________________Fax# (Work)___________________
Siblings: (Names and Ages):_________________________________________
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THIS REFERENCE SHEET WILL BE USED IN CASE OF AN EMERGENCY.
Contact person in the event of an emergency if parents can not be reached. This
person should be available during school hours.
Name: _____________________________Phone:_______________________
Family Physician:____________________Phone:________________________
If your parents allow us to give Tylenol or Advil, if you request it for headaches or
minor pain, they should sign below.
Parent’s Signature:_______________________________________________
Please list serious allergies, prescription medication that affects class work, or any
health problems or physical limitations that need to be brought to our attention. Use
the back if necessary.
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Page 2: Application for New Student
Give a copy of the enclosed recommendation letter to two people: a former teacher, tutor, church pastor, employer or personal contact.
Names of people given to:_____________________ _____________________
Home Congregation:________________________________________________
Pastor or Youth Pastor:_________________________Phone:________________
Last school attended:________________________________Year:____________
Did you leave the school in good standing?_______________________________
Have you ever been expelled or suspended from any school?__________________
If yes, please explain the circumstances:__________________________________
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Summarize your educational history. Tell us where you have been to school and what you have liked or disliked about each:
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Please enclose copies of your grades for the last two years. (DO NOT give us originals nor do we want your school transcripts. We just need to see your educational habits.) What is your GPA? ’06-'07___ ’07-'08____
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Page 3: Application for New Student
List any home school group classes which you have attended:________________
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Please list names and phone #’s of the directors of these programs.
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Tell us about your college plans. What is your primary interest as a course of study?
What career dreams do you have?_____________________________________
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You must be registered with an umbrella organization to participate in our program.
Which one has accepted your registration?
________________________________________________________________
You must also be a member of MTHEA for insurance purposes. Are you?________
If you work, tell us about your job and approximately how many hours a week you
Work.____________________________________________________________
________________________________________________________________
Do you have any hobbies, interests, music or sport activities that you are involved
With?____________________________________________________________
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List any families currently attending RTA whom you know:
________________________________________________________________
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Page 4: Application for New Students
Finish this page with whatever will help us to understand and appreciate you. Don’t
agonize over this. Be yourself and write as neatly and as correctly as you can. Use
a dictionary if you like, but accept no other assistance. Include special interests,
talents, and hobbies. Show us your sense of humor. Introduce yourself to us in your
own way. Let us know what special qualities you possess which will enrich our lives.
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