SCHOOL HOURS
Monday-Thursday @ 8:15 AM-4:00 PM

International Student Application

Please fill out carefully and completely.

Student Information

Date

Student’s Full Legal Name
 
 
Grade Applying For


Address


City
 

Prefecture
 

Country
 

Zip


Phone
 

Date of Birth
 

Age
       Male        Female 

Birthplace
 

Student Email

Father's Information

Father’s Name:


Occupation
 

Employer

 
Father’s Cell Phone
 

E-mail

Mother's Information

Mother’s Name


Occupation
 

Employer


Mother’s Cell Phone
 

E-mail


Family Information

Family Status:        
Married       Divorced       Widowed       Remarried       Single Parent

If the child is not living with both parents, please explain with whom he lives: 
Mother Only        Father Only       Other

If you checked “other,” please explain.

School Experience

Has your child ever been expelled?  Yes   No       
Has your child ever been retained?  Yes   No        
Which grade?

School Attended Last Year


Email
 

Address


City
 

Prefecture
 

Country
 

Zip


Phone


  Passed       Passed on probation       Retained in grade

If your child has any discipline or emotional problems, please explain.


If your child has any disabilities or academic problems, please explain.


Please check any of the classes you have already taken or are currently taking.
  Algebra 1                    Physical Science
  Algebra 2                    Biology
  Geometry                   Chemistry
  Calculus




Pay Application Fee
*Applications will not be reviewed until application fee has been submitted.


CONTACT INFORMATION
14855 S. Leland Rd. • Beavercreek, OR 97004  |  Phone: (503) 732.2020