Mounds Park Academy : Apply Now

Thank you for your interest in Mounds Park Academy. We look forward to meeting you and your child.
Please complete the following Application Form; note that the fields marked by an * are required.

Applicant Information

Full Name of Applicant:	*
Preferred Name:
Gender:	*
Applying For Grade:	*
For School Year:	*
Date Of Birth:	*
Current School:	*
Ethnicity: (Optional)

Interests

Parent #1 Information

Name of Parent/Guardian:	*
Address:	*
City/State/Zip:	*
Home Phone:	*
Work Phone:
Cell Phone:
E-Mail Address:	*
Employer:	*
Title:	*

Parent #2 Information

Name of Parent/Guardian:
Address:
City/State/Zip:
Home Phone:
Work Phone:
Cell Phone:
E-Mail Address:
Employer:
Title:

Marriage Status and Custody Information

Marriage Status of Parents:

If there is joint custody, check here

If parents are separated or divorced, who has primary custody?

Person(s) legally responsible to make educational decision for the applicant:

Note: In cases of divorce, a copy of appropriate documentation demonstrating legal custody must be submitted to the Office of Admission to be included as part of the applicant’s confidential file.

Financial Aid Information

Do you intend to apply for financial aid at Mounds Park Academy?

Financial aid application forms are available. You are encouraged to submit an online application with School and Student Services for Financial Aid (SSS) through our Web site.

The financial aid application deadline is March 1, 2010.
We will communicate the financial aid award decisions on April 2, 2010.

General Information

Applicant's Siblings

Name:

Date of Birth:

Has the applicant ever been suspended or not invited back to a school?

Please Explain:

What need(s) or circumstances, if any, may require special accommodations throughout the course of the applicant’s education?

Note: Copies of all past and current assessments, diagnoses, and accommodation plan must be submitted and will be included as part of the applicant’s confidential file. An offer of admission does not imply that MPA will assume responsibility for all accommodations where such measures constitute a substantial modification to the mission and/or curriculum.

How did you hear about MPA?

Please rank the three most important factors in your school choice:

	Academic curriculum
	Faculty credentials
	Extracurricular activities
	Overall cost
	Safety
	Distance from home
	Family/friends attend
	Class Size

Students applying to Middle School (Grades 5-8) or Upper School (Grades 9-12)

In the space provided, please complete the following three questions independently. *Note: Students should type these responses.*
Please list your hobbies, clubs of which you are a member, or volunteer work you have done, and a few things you gained by participating in each.
Please tell us what we should know about you as a student and a person when reviewing your application.
Please write your reasons for applying to Mounds Park Academy. What do you hope to gain from MPA and what do you hope to contribute to it?

Parents/Guardians of student applying for Lower School (Pre-Kindergarten through Grade 4)

In the space provided, please submit information on your child’s activities, hobbies and interests.

I certify that the information on this application is correct and complete and understand that any falsification or misrepresentation may disqualify the applicant for admission or may later be grounds for the student’s dismissal from Mounds Park Academy. My electronic signature also indicates my understanding that any recommendations submitted on behalf of the applicant are the property of Mounds Park Academy and will be kept confidential from me. My signature also indicates my understanding that an application is not fully complete until all documentation (recommendation forms, academic records, day visit, academic assessment, and family interview and the $50 non-refundable application fee) is received and completed.

In lieu of a signature, please enter your name in the box exactly how it is displayed:

Please enter the text in the box below to help comeplete the admission process.