Middle School Online Application

Student

Student's Name

First Last

Grade

Date of Birth*

MM

DD

YYYY

Gender

Female
Male
Prefer not to say

Parent 1

Name*

First Last

Address*

Street Address Address Line 2 City State ZIP Code

Home Phone*

Other Phone

Email

Employer

Parent 2

Name

First Last

Address

Same as Parent 1

Street Address Address Line 2 City State ZIP Code

Home Phone

Other Phone

Email*

Employer

About You and Your Child

Please list prior schools attended by your child in the last 3 years (with complete addresses so that we can request transcripts)*

What is your understanding of the Education for Life philosophy?*

How do you feel our school will be able to meet the needs of your child?*

Describe any physical, emotional, or mental health challenges your child has had. How have these challenges been addressed, and with what results?*

Describe any spiritual or religious practices your family follows and your child’s response. Has your family practiced yoga and/or meditation?*

What skills (music, sports, crafts, etc.) has your child developed? How many hours per week does he/she spend in these activities?*

Has your child been involved with recreational use of drugs or alcohol? If yes, please explain*

Describe any other events or influences that have had a significant impact on your child.*

Please rate the frequency your child displays these qualities:

Cheerfulness*

Compassion*

Responsibility*

Courage*

Self-control*

Intellectual Curiosity*

Honesty*

Cooperation*

High Energy Level*

Openness to Guidance*

Creativity*

Submitting the Online Application

Questions

Middle School Application

Student

Parent 1

Parent 2

About You and Your Child

Please rate the frequency your child displays these qualities:

Living Wisdom School

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