Common Application

The secondary schools listed on the inside of this application have worked together to develop the Secondary School Common Application. The application should be completed once; only photocopies should be sent to the schools to which the student is applying. The same is true for the Transcript Release Form and the Common Recommendation Form. Please keep the original for your records.

STEPS FOR COMPLETING THE COMMON APPLICATION:

GET STARTED Call each school to which you are applying: l Ask if the school is accepting the Secondary School Common Application and if additional application materials are required. l Check the application deadline and testing requirements. l Schedule a visit and an interview. l Verify how many recommendations are required and from whom. l Please ask for and make a note of all application deadlines.

SUBMIT A COMPLETED APPLICATION l Complete Sections A & B. l Make a photocopy for each school to which your child is applying. l Mail your completed, photocopied application, along with the appropriate fee, to the admission office of each school to which you are applying. The addresses are listed on the inside cover of this packet. l Keep a copy of everything you submit including the original copy of the Common Application.

REQUEST SCHOOL RECORDS AND RECOMMENDATIONS l Check the boxes on Section C for each school to which you are applying. l Complete Section C and the top of Section D. l Give Sections C and D to your child’s current school.

APPLY FOR FINANCIAL AID l If you wish to apply for financial aid, please check “yes” on Page 1 of Section A of the

application. Each school to which you are applying will send you the necessary forms. COMMON COMMON APPLICATION

AUGUST 2008 Independent Schools of St. Louis Secondary School Common Application Participants

Barat Academy Gateway Academy Thomas Jefferson School Coeducational; grades 9–12; Coeducational; grades JK-12 Coeducational; grades 7–12; day school; Catholic day school; Catholic day, five-day boarding, and Michael Wade, Director of Admissions Mary Burke, Director of Admissions full-time boarding school; non-sectarian #1 Academy Place 17815 Wild Horse Creek Rd. Marie De Jesus, Director of Admissions Dardenne Prairie, MO 63368 Chesterfield, MO 63005 4100 South Lindbergh Boulevard Phone: (636) 300-9060 Phone: (636) 519-9099 St. Louis, MO 63127 Fax: (636) 300-9061 Fax: (636) 449-1627 Phone: (314) 843-4151 E-mail: [email protected] E-mail: [email protected] Fax: (314) 843-3527 Application fee: $60 Application fee: $30 E-mail: [email protected] Application fee: $40 for domestic Chaminade College John Burroughs School Application fee: $100 for international Preparatory School Coeducational; grades 7–12; All boys; grades 6–12; day and day school; non-sectarian Villa Duchesne and Oak Hill School resident school; Catholic Caroline LaVigne, Director of Admissions All girls; grades 7-12; Matthew Saxer, Director of Admissions 755 South Price Road Coeducational; grades JK-6 425 S. Lindbergh Blvd. St. Louis, MO 63124 day school; Catholic St. Louis, MO 63131-2799 Phone: (314) 993-4040 Mary Stevens, Director of Admissions Phone: (314) 993-4400 X150 Fax: (314) 567-2896 801 South Spoede Road Fax: (314) 993-5732 E-mail: [email protected] St. Louis, MO 63131 E-mail: [email protected] Application fee: $40 Phone: (314) 810-3451 Application fee: $50 for day Fax: (314) 432-0199 Application fee: $150 for international Mary Institute & Saint Louis Country Day E-mail: [email protected] School Application fee: $40 The College School Coeducational; grades JK–12; Coeducational; grades Pre–8; day school; non-sectarian Visitation Academy day school; non-sectarian Peggy Laramie, Director of Admissions All girls; grades 1-12; Adrienne Rusbarsky, Director of Admissions 101 North Warson Road Coeducational Montessori; 2 yrs.-K #1 Newport Place St. Louis, MO 63124 day school; Catholic St. Louis, MO 63119 Phone: (314) 995-7367 Ashley Giljum, Director of Admissions Phone: (314) 962-9355 Fax: (314) 872-3257 3020 North Ballas Road Fax: (314) 962-5078 E-mail: [email protected] St. Louis, MO 63131 E-mail: [email protected] Application fee: $40 Phone: (314) 625-9103 Application fee: $100 Fax: (314) 432-7210 Missouri Military Academy E-mail: [email protected] Crossroads College Preparatory School All boys; grades 6-12; Application fee: $75 Coeducational; grades 7–12; Resident school, non-sectarian day school; non-sectarian Greg Seibert, Director of Admissions Westminster Christian Academy Maggie Baisch, Director of Admissions 204 Grand Avenue Coeducational; grades 7–12; 500 DeBaliviere Mexico, MO 65265 day school; Christian St. Louis, MO 63112 Phone: 1-888-564-6662 Peggy Johnson, Director of Admissions Phone: (314) 367-8085 Fax: (573) 581-0081 10900 Ladue Road Fax: (314) 367-9711 E-mail: [email protected] St. Louis, MO 63141 E-mail: [email protected] Application fee: $100 Phone: (314) 997-2900 Application fee: $50 Fax: (314) 997-2903 Solomon Schechter Day School E-mail: [email protected] The Fulton School at St. Albans Coeducational; grades K–8; Application fee: $50 Coeducational; grades PK-12; day school; Jewish day school; non-sectarian Sue Albert, Director of Admissions Whitfield School Kara Douglas, Director of Admissions 348 S. Mason Road Coeducational; grades 6–12; 123 Schoolhouse Road St. Louis, MO 63141 day school; non-sectarian P.O. Box 78 Phone: (314) 576-6177 Cynthia Crum Alverson, St. Albans, MO 63073 Fax: (314) 576-3624 Director of Admission Phone: (636) 458-6688 E-mail: [email protected] 175 South Mason Road Fax: (636) 458-6660 Application and assessment fee: $100 St. Louis, MO 63141 E-mail: [email protected] Phone: (314) 434-5141 Application fee: $50 Saint Louis Priory School Fax: (314) 434-6193 All boys; grades 7–12; E-mail: [email protected] day school; Catholic Application and testing fee: $75 Tom Mulvihill, Director of Admission 500 South Mason Road St. Louis, MO 63141-8500 Phone: (314) 434-3690, #101 Fax: (314) 576-7088 E-mail: [email protected] Application fee: $35 Secondary School Common Application Section A (Parent) Photo (optional) Parents or guardians of the applicant are asked to complete Section A. Please print or type. Applicants are asked to complete Section B.

Applicant Information

Applicant’s legal name Last first middle lFemale lMale preferred name

Age Date of Birth (month/day/year) place of Birth

Applying for grade Month/Year Current grade

Citizenship: l US l Other (Please specify):______Language(s) spoken at home (other than English):______

Mailing address Street city State Zip

Home telephone ( ) fax ( ) Student E-mail

Will the applicant be requesting financial aid? lYes lNo

The following question is OPTIONAL and is used for statistical purposes only. Please check all that apply. l African American l Caucasian l Latino/Hispanic American l Pacific Islander American l Asian American l Native American l Middle Eastern American l Other

For applicants applying to religiously affiliated schools: (Optional for other schools)

religion of: Student: parent(s):

place of worship:

Current school School district in which applicant resides

School address Street Address city State Zip School Telephone ( ) Fax ( ) Principal/Head

Dates of attendance

Other school(s) previously attended:

name Address telephone Dates of Attendance

name Address telephone Dates of Attendance 1 FAMILY Information

Student resides with (check all that apply): lFather lMother lStepfather lStepmother lParents separated lParents divorced lOther (please specify) ______

Correspondence should be sent to: lBoth parents lFather lMother lOther (please specify) ______

Name of parent or guardian: lDeceased Name of parent or guardian: lDeceased lDr. lMr. lMrs. lMs. lOther (please specify)______lDr. lMr. lMrs. lMs. lOther (please specify)______First Middle Last First Middle Last

Maiden name:______Maiden name:______Preferred name: ______Preferred name: ______Relationship to applicant:______Relationship to applicant:______Home address:______Home address:______Street Street ______City State Zip City State Zip

If applicable, name of stepparent: If applicable, name of stepparent: lDr. lMr. lMrs. lMs. lOther (please specify)______lDr. lMr. lMrs. lMs. lOther (please specify)______First Middle Last First Middle Last

Home telephone: ( )______Home telephone: ( )______Cell: ( )______Cell: ( )______E-mail: ______E-mail: ______Position:______Position:______Employer:______Employer:______Address:______Address:______Street Street ______City State Zip City State Zip Telephone:( )______Fax:( )______2 Telephone:( )______Fax:( )______Please list names of applicant’s brothers and sisters, their ages, schools (colleges) they now attend, and their grades/years in school.

name Age School Grade/Year

If the applicant has had any relatives who have graduated from the school(s) to which the student is applying, or if any relatives currently attend, please list their names (include maiden names where applicable), relationship to applicant and the years they attended. You are welcome to attach applicable legacy information for each school on separate pieces of paper.

name relationship to Applicant School Years attended

If there are circumstances which have affected or may affect the applicant’s academic performance, participation in athletics, or attendance in school, please describe (e.g., frequent moves/change of school, separation/loss of a significant person in the family, disciplinary action, illness, learning difference, skipping or repeating a grade).

If there is any additional information you believe would be helpful for the admission committee(s) to review, please describe.

3 Statement of Confidentiality: It is the policy of all members of the Independent Schools of St. Louis that all information received regarding a candidate’s application for admission will be treated with complete confidentiality. Only authorized school personnel have access to this information and then only to the extent that the information is relevant to admission and placement decisions. Information received within the scope of this policy is not disclosed to the applicant or to the applicant’s family.

I/We hereby state that the information contained herein is true and complete. I/We have not knowingly omitted any pertinent information regarding my/our child’s academic, medical or behavioral history.

Signature of parent(s)/guardian(s):

Signature Date

Secondary School Common Application Section B (Student)

This section is to be completed by the applicant.

Print full name First middle last

Preferred Name l Female lMale Applying to grade

Name of present school:

Please write about your involvement in any of the activities listed below, being as specific as possible. Although you are not expected to be involved in all of the areas listed below, we want you to have the chance to write about those in which you have taken an active interest.

Visual Arts

Athletics

Community Service/Family Responsibilities

Drama/Literary/Music

Math/Science

Hobbies

Other Activities

5 Please use the space provided to write about one of the following topics as a way to tell us more about you. • A skill or trait you have of which you are proud • An experience or achievement which influenced your life • A person who has been important to you

6 Check the box to the left of each school to which your child is applying and complete the Transcript Release Form on the reverse side. Give this completed form to your child’s school, along with the Common Recommendation Form, on which you Secondary School Common Application supplied the applicant’s name and current school. Section C (School) l Barat Academy l Missouri Military Academy Michael Wade, Director of Admissions Greg Seibert, Director of Admissions #1 Academy Place, Dardenne Prairie, MO 63368 204 Grand Avenue, Mexico, MO 65265 Phone: (636) 300-9060 Phone: 1-888-564-6662 Fax: (636) 300-9061 Fax: (573) 581-0081 Application Deadline: November 12, 2008 Application Deadline: Rolling admissions l Chaminade College Preparatory School Solomon Schechter Day School Matthew Saxer, Director of Admissions l Sue Albert, Director of Admissions 425 S. Lindbergh Blvd., St. Louis, MO 63131-2799 348 S. Mason Road, St. Louis, MO 63141 Phone: (314) 993-4400 X150 Phone: (314) 576-6177 Fax: (314) 993-5732 Fax: (314) 576-3624 Application Deadline: December 1, 2008 (HS) Application Deadline: January 31, 2009 Application Deadline: February 2, 2009 (MS) l The Saint Louis Priory School l The College School Tom Mulvihill, Director of Admissions Adrienne Rusbarsky, Director of Admissions 500 South Mason Road, St. Louis, MO 63141-8500 #1 Newport Place, St. Louis, MO 63119 Phone: (314) 434-3690, #101 Phone: (314) 962-9355 Fax: (314) 576-7088 Fax: (314) 962-5078 Application Deadline: January 23, 2009 Application Deadline: February 4, 2009 l Thomas Jefferson School l Crossroads College Preparatory School Marie De Jesus, Director of Admissions Maggie Baisch, Director of Admissions 4100 South Lindbergh Boulevard, St. Louis, MO 63127 500 DeBaliviere, St. Louis, MO 63112 Phone: (314) 843-4151 Phone: (314) 367-8085 Fax: (314) 843-4152 Fax: (314) 367-9711 Application Deadline: December 8, 2008 (early decision) Application Deadline: January 15, 2009 Application Deadline: February 16, 2009 (regular decision) l The Fulton School at St. Albans l Villa Duchesne and Oak Hill School Diane Loyd, Director of Admissions Mary Stevens, Director of Admissions 123 Schoolhouse Road, P.O. Box 78, St. Albans, MO 63073 801 S. Spoede Road, St. Louis, MO 63131 Phone: (636) 458-6688 Phone: (314) 810-3451 Fax: (636) 458-6660 Fax: (314) 432-0199 Application Deadline: Rolling admissions Application Deadline: November 12, 2008 (9th) l Gateway Academy Application Deadline: January 23, 2009 Mary Burke, Director of Admissions l Visitation Academy 17815 Wild Horse Creek Rd., Chesterfield, MO 63005 Ashley Giljum Director of Admissions Phone: (636) 519-9099 3020 North Ballas Road, St. Louis, MO 63131 Fax: (636) 449-1627 Phone: (314) 625-9103 Application Deadline: Rolling admissions Fax: (314) 432-7210 l John Burroughs School Application Deadline: November 12, 2008 (9th) Caroline LaVigne, Director of Admissions Application Deadline: January 23, 2009 755 South Price Road, St. Louis, MO 63124 l Westminster Christian Academy Phone: (314) 993-4040 Peggy Johnson, Director of Admissions Fax: (314) 567-2896 10900 Ladue Road, St. Louis, MO 63141 Application Deadline: January 15, 2009 Phone: (314) 997-2900 Fax: (314) 997-2903 l Mary Institute & Saint Louis Country Day School Application Deadline: January 15, 2009 Peggy Laramie, Director of Admissions l Whitfield School Cynthia Crum Alverson, Director of Admission 101 North Warson Road, St. Louis, MO 63124 175 South Mason Road, St. Louis, MO 63141 Phone: (314) 995-7367 Phone: (314) 434-5141 Fax: (314) 872-3257 Fax: (314) 434-6193 Application Deadline: January 15, 2009 Application Deadline: January 15, 2009 (early decision) Application Deadline: January 15, 2009 (regular decision) 7

Transcript Release Form (Section C) Parents: Please give this form to your child's current school. Records must be sent directly from the current school. I/We authorize the release of my/our child’s: • grades from the past two school years and the current school year • aptitude and achievement test scores • interpretation of grading scales • psychological and special needs testing results • attendance and disciplinary records • immunization and medical records • current teacher recommendation

If accepted, I/we authorize release of the full record when transfer occurs.

I/we authorize the school(s) checked to contact schools and other sources to obtain information relative to my/our child’s application. I/We will not seek access to confidential recommendation and evaluation materials before or after the admission decision is made.

Applicant’s full name:______First Middle Last

Applying for grade:______Enrolling:______DOB: ______Month/Year Month/Day/Year

Current School:______

School Address:______Street Address City State Zip

School phone: ( )______School fax: ( )

Statement of Confidentiality: It is the policy of all members of the Independent Schools of St. Louis that all information received regarding a candidate’s application for admission will be treated with complete confidentiality. Only authorized school personnel have access to this information and then only to the extent that the information is relevant to admission and placement decisions. Information received within the scope of this policy is not disclosed to the applicant or to the applicant’s family.

Signature(s) of parent(s)/guardian(s):

______Signature Date

Common Recommendation Form for Children Applying to Grades 5 through 12 Section D Parents: Please submit this form to one of your child's current teachers. Include with each recommendation, an addressed and stamped envelope for each school to which you would like the completed recommendation sent. Teachers: Please keep the original and send copy(ies) directly to the school(s) to which the student is applying. This form may be duplicated if more than one teacher is recommending.

Applicant’s full name:______First Middle Last

Applicant’s current school: ______Current grade:______

The student named above is applying for admission to one or more secondary school members of the Independent Schools of St. Louis. As part of the admission process, we appreciate your cooperation in completing this form. This evaluation and its contents will be used only in connection with the admission decision by the ISSL schools using the Common Application for Secondary Schools. ISSL member schools will not share reasons for an applicant being denied admission. If you wish to discuss this in person rather than completing this form, please check the box below, sign and return this form with your telephone number(s). A representative from the admission office will contact you shortly. Best time:______l I would like to discuss the applicant personally rather than completing this form. Contact #:______Name of person completing this form:______Print Name My relationship with this student has been that of (check all that apply): lSchool Counselor lSchool Administrator lTeacher (please specify subjects)______lOther (please specify)______

I have known this student for: ______Years______Months Daytime phone: ( )______

______Signature Date

The items that follow ask for your sense of this student’s relationship within the school community, emotional and social growth and intellectual development. Your insight will help us to know this child. We understand the difficulty in evaluating a student, and we are aware that children are constantly growing, changing and developing. The information you provide will be kept in strictest confidence and used only by the admission committee.

What are the first words that come to mind when describing this student? ______

What are the student’s special interests or abilities?

______

9 We would appreciate your comments and observations concerning the strengths, weaknesses, learning style, health, behavior or special needs of this student. Feel free to attach an additional sheet of paper if necessary.

______

Please comment on the parents’ support of their child’s learning and their cooperation with the school.

______

Does this school have a program for special needs students (gifted, learning disabled, etc.)? lYes lNo

If yes, is this student involved in a program? lYes lNo Name of program:______For how long has this student been involved? ______Years ______Months Has the applicant ever been suspended, dismissed, requested to withdraw or otherwise penalized or disciplined for any reason? lYes lNo If yes, please state the nature of the action taken and describe the circumstances relating to the action. Please provide the names of the teachers or administrators involved. ______

______Please rate this student compared to other students you have taught on the scale below as it relates to each category listed. (This form may be duplicated if more than one teacher wishes to complete this scale.)

Personal Qualities Needs Personal Qualities Outstanding Above Average Average Fair Improvement Work ethic Conduct Consideration for others Relationships with peers Relationships with adults Emotional maturity Self-confidence Sense of humor Honesty Sense of responsibility Leadership skills

Academic Qualities Needs Outstanding Above Average Average Fair Improvement

Motivation to learn Intellectual curiosity Ability to work in a group Ability to work independently Organizational skills Work habits Creativity Class preparation Class participation Academic promise Academic achievement 10 For additional information about all Independent Schools of St. Louis members, please contact:

Genie Newport Guilliams, Executive Director Independent Schools of St. Louis 425 S. Lindbergh Boulevard St. Louis, MO 63131 (314) 567-9229 www.independentschools.org ISSL What are the steps in Whitfield’s admission process? 1. Schedule an on-campus family interview and tour. Both parents are strongly encouraged to attend the family interview and tour with their child. The appointment takes approximately 75 minutes and may be scheduled between September 29, 2008 and January 16, 2009. Please call (314) 434-5141 to arrange your family interview and tour. You do not need to have your application completed prior to your family interview and tour.

2. Submit application materials, postmarked by January 15, 2009. A complete Whitfield application includes the following items: • A copy of a completed Independent Schools of St. Louis (ISSL) Common Application (Sections A and B) • Whitfield’s application supplement (Section E), which is attached to this sheet • $75 application/testing fee • Two character references • No forms are required for these recommendations. • Please ask two people from outside your child’s school to write recommendations and send them directly to Cynthia C. Alverson, Director of Admission, Whitfield School, 175 South Mason Road, St. Louis, MO 63141 or to [email protected]. A neighbor, a coach, a piano teacher or a religious leader is an excellent person to ask for a recommendation. Whitfield welcomes but neither encourages nor requires letters from former or current teachers beyond the required Section D; Whitfield asks for two independent, non-school letters in addition to any recommendations from school personnel. • These letters must be postmarked by January 15, 2009. • Whitfield School sends acknowledgement postcards to those writing recommendations so everyone knows the letters have arrived. • Records from your child’s current school. Complete Section C and the top of Section D of the ISSL Common Application and give these sections to your child’s school. Your school will forward records to Whitfield at the conclusion of the first semester or trimester. • We will call you if we are missing any application materials.

3. Plan to attend the Whitfield Open House on Sunday, October 26, 2008. The formal program begins at 3:00 p.m.

4. Mark the Saturday, January 24, 2009 admission test date/prospective parent forum on your calendar. Families that apply by January 15 are automatically registered for Whitfield's admission test and prospective parent forum on Saturday, January 24, 2009, at 9:30 a.m. Whitfield requires that all applicants take the Whitfield admission exam; in addition, families may submit ISEE scores.

5. Whitfield encourages parents who want more in depth information about the School to attend Parent Outreach. Under separate cover, prospective parents will receive a postcard explaining in greater detail the opportunity to spend a morning at Whitfield, talking with current Whitfield parents and teachers and visiting classes. Like classes at Whitfield, enrollment at Parent Outreach is limited to 15. The 2008-2009 Parent Outreach dates are as follows: • Wednesday, October 29, 2008 • Wednesday, January 28, 2009 • Thursday, February 26, 2009 • Thursday, April 23, 2009

6. Students are welcome to spend a morning visiting Whitfield classes. That date may be arranged when parents call to schedule their family interviews and tours.

Whitfield School 175 South Mason Road St.Louis, Missouri 63141 tel: 314.434.5141 fax: 314.434.6193 www.whitfieldschool.org What is Early Decision? Early Decision is an opportunity for students and families who are committed to attending Whitfield to find out early if they have been admitted. Early Decision candidates are the first candidates reviewed by the Admission Committee and receive priority in the admission process. Families indicate their intent to apply under the Early Decision plan on Section E. Only a $75 application and testing fee is due with a child's application.

When are decision letters mailed? Early Decision notifications will be mailed February 13, 2009. If a child is admitted under the Early Decision plan, a $2,500 non-refundable Early Decision Deposit and enrollment contract must be postmarked by February 20, 2009. $1,000 of the non-refundable Early Decision Deposit is a permanent deposit; $1,500 of the non-refundable Early Decision Deposit is applied toward tuition. Only a $75 application and testing fee is due with a child's application.

Regular Decision notifications will be mailed March 12, 2009. If a child is admitted under the Regular Decision plan, a $1,000 non-refundable Permanent Deposit and enrollment contract must be postmarked by April 6, 2009.

Whitfield intends to maintain a wait list as the School does every year, and families will be notified by phone when spaces become available. Whitfield will release students from the wait list after June 8, 2009.

We look forward to meeting your family and getting to know you in the coming months. Should you have any questions or concerns, please call us at (314) 434-5141 or e-mail us. Thank you for your interest in Whitfield School.

ADMISSION STAFF: Cynthia Crum Alverson Director of Admission and College Counseling [email protected]

Emily R. Chrysler Assistant Director of Admission [email protected]

Ellie W. Svenson Assistant Director of Admission [email protected]

Debbie Thaxton Administrative Assistant [email protected]

Whitfield seeks to maintain a student body diverse in geographic, economic, racial and religious backgrounds. It does not discriminate on the basis of race, religion or color in administering its academic policies, athletic policies, financial aid program or other school activities. Section E (Whitfield Application Supplement)

Parents or guardians of the applicant are asked to complete Section E.

Applicant’s legal name ______First Middle Last

All applications must be postmarked by January 15, 2009.

Early Decision Option

 I/We are interested in Whitfield’s Early Decision plan. Early Decision notifications will be mailed February 13, 2009. If a child is admitted under the Early Decision plan, a $2,500 non-refundable Early Decision Deposit and enrollment contract must be postmarked by February 20, 2009. $1,000 of the non-refundable Early Decision Deposit is a permanent deposit; $1,500 of the non-refundable Early Decision Deposit is applied toward tuition. Only a $75 application and testing fee is due with a child's application.  I/We would prefer to remain in Whitfield’s Regular Decision pool. I/We understand that admission decisions will be mailed March 12, 2009, with a $1,000 non-refundable Permanent Deposit and enrollment contract postmarked by April 6, 2009.

 I/We are undecided at this time. I/We understand that I/we may opt later for Whitfield’s Early Decision plan. Make your request in writing to Cynthia Alverson postmarked by January 15, 2009.

Character References You are responsible for requesting these recommendations. Please list below the names and addresses of the two people from outside your child's school you have asked for recommendations on your child's behalf. Please see the directions for more information.

______First Name Last Name Street Address City State Zip

Additional Parent Information The School makes every effort for its records to be accurate and complete. Please provide the following information to complete your records.

Father’s College______Degree______

College______Degree______

Mother’s College______Degree______

College______Degree______

Whitfield School 175 South Mason Road St.Louis, Missouri 63141 tel: 314.434.5141 fax: 314.434.6193 www.whitfieldschool.org 2008-2009 Grandparent Information Whitfield includes students’ grandparents in an array of mailings and programs such as Grandparents Day. Please share with the School the information following:

Maternal grandfather______Title First Name Middle Name Last Name Suffix Nickname

Maternal grandmother______Title First Name Middle Name Last Name Suffix Nickname

Home address______Street Address City State Zip

How would you like this Home Phone ______( ) mail to be addressed?______

Paternal grandfather______Title First Name Middle Name Last Name Suffix Nickname

Paternal grandmother______Title First Name Middle Name Last Name Suffix Nickname

Home address______Street Address City State Zip

How would you like this Home Phone ______( ) mail to be addressed?______

Financial Responsibility To whom should the School send tuition statements?

______Title First Name Middle Name Last Name Suffix Relationship to Applicant

______Street Address City State Zip Telephone Number

Signature of parent(s)/guardian(s): I/We hereby state that the information contained in the application in its entirety to Whitfield is true and complete and acknowledge that providing incomplete or false information can result in denial of admission, or if already admitted, the student's removal from school.

______Signature Date

Please remember to enclose the $75 application and testing fee with your application.