*Please print the form and send it by mail*
APPLICATION FORM
Personal Information:
Legal Name__________________________________________
Last First Middle
Mailing Address________________________________________
Number and Street Name
_______________________________________________________
City State Zip Code
_____________________
Country
E-mail address________________________
Date of Birth_________________ Age_______ Sex: M F
Month/Day/Year
Place of Birth_______________________________
Country Issuing Passaport:_____________
Reglious affiliation:______________Home Church_____________
Please write the name and address of a family,friend or relative in United States: __________________________________________
Do you play a musical instrument? Yes No Which one?________
Do you sing in a chorale? Yes No What voice?_________
Do you play any sports? Yes No What sport?____________
EDUCATIONAL BACKROUND
What school did you last attend?___________________________
How many years have you studied English?___________________
Please rate your ability in English in the following areas.
Poor Good Very good
Reading 1 2 3 4 5 6 7 8 9 10
Writing 1 2 3 4 5 6 7 8 9 10
Understanding spoken 1 2 3 4 5 6 7 8 9 10
Speking 1 2 3 4 5 6 7 8 9 10
FAMILY INFORMATION
Mother's name_____________________________________
Address__________________________________________
Home Phone_________________
E-mail______________________
Occupation and Employer_____________________________
Work Phone_______________
Father's name______________________________________
Address___________________________________________
Home Phone_________________
E-mail______________________
Occupation and Employer______________________________
Work Phone________________
STUDENT QUESTIONNARIE
1.Have you ever withdrawn or been suspended form school?
YES NO
If yes, when and why?___________________________________
2.Have you been involve in or arrested for any crime?
YES NO
If yes, when and why?___________________________________
3.Have you used tobacco or alcohol within the past year?
YES NO
STUDENT PLEDGE
By signing this applicacion, I am agreeing to uphold the standards and principles of the school. If accepted, I aggree to live in accordance with these standarts and principles or any announced regulations.
Signature of Student________________________
PARENT PLEDGE
By signing this application, I am sifnifying my support of the standards and principles of HVA. I agree to be responsible for my child's financial obligations
Signature of Parent/Guardian______________________
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With the application the student have to send 3 recomendations forms. Relatives can not complete the form.
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Cada estudante deve ter seu ticket de regresso e U$2000 no momento de sua chegada a Highland View Academy.O precio 3.500 pelo semestre.
As classes comecarao em 10 de janeiro. Antes disso a escola estara fechada.
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FORMULARIO DE RECOMENDACAO
______________________________pede admissao no Highland View Academy. Seu nome foi dado como referencia. Por favor, responda as questoes seguintes pelo melhor de sua bilidade. (Esse formulario sera mantido em comfidencia restrita)
1.Quanto tempo faz que voce conhece o candidato?___________
2.Em que capacidade? (Professor, pastor, etc)?______________
3.E ativo nas atividades da igreja? Sim Quase sempre Nao
4.Se ralaciona bem com os outros? Sim Quase sempre Nao
5.Se relaciona bem com os adultos? Sim Quase sempre Nao
6.Se porta como um cristao em seu estilo de vida e aparencia geral?
Sim Quase sempre Nao
7.Pelo seu conhecimiento, ja usou cigarro, charuto, etc?
Sim Quase sempre Nao
8.O candidato, pelo seu conhecimiento, ja usou alcool?
Sim Quase sempre Nao
9.Seria um aluno desejavel em uma institucao adventista?
Sim Nao
10.Voce gostaria que o candidato dividisse um quarto com seu filho ou filha?
Sim Nao
11.Como voce graduaria o candidato pela sua influencia espiritual sobre os outros?
EXELENTE MUITO BOA BOA PASIVA MALA INFLUENCIA
12 Por favor marque a coluna(X) que melhor descreve o candidato:
Sempre Generalmente Nunca
Honesto/a ___ ___ ____
Trabalhador/a ___ ___ ____
Temperamento controlado ___ ___ ____
Emocionalmente estavel ___ ___ ____
Academicamente motivado ___ ___ ____
Responsavel ___ ___ ____
Influencia e Lideranca ___ ___ ____
Data:___________ Ass_________________Titulo_____________
Por favor inclua comentarios adicionais se deseja
Mande separado pelo correio para:
ESL Recommendation
HVA 10100 Academy Drive
Hagerstown 21740
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