Online Application For Admission

Name*

First Middle Last

Please Upload a Current Photo of the Applicant*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Home Phone*

Mother's Phone - Work or Cell*

Father's Phone - Work or Cell*

Student Gender*

Male
Female

Date of Birth*

Ethnicity*

Please enter the student's ethnicity in the blank provided.

Applying for entrance into school year beginning September*

What grade will the student be entering in that year?*

Currently Attending What School?*

Student's Current Grade*

Estimated Grade Average in English at Current School*

A, B, C, etc.

Estimated Grade Average in Math at Current School*

A, B, C, etc.

Current Math Course*

Pre-Algebra, Geometry, etc.

Previous Schools Attended and Dates:*

If student hasn't attended any other schools, please type "NA"

Family's Religious Affiliation*

Father's Name*

First Middle Last

Father a Veteran?*

Yes
No

What Military Branch?*

Father's Email Address*

Father's Profession and Place of Employment*

Father's Education*

Please include the name of institution, degree and year completed. Please enter "NA" if there was no secondary education.

Mother's Name*

First Middle Last

Mother a Veteran?*

Yes
No

What Military Branch?*

Mother's Profession and Place of Employment

Mother's Education*

Please include the name of institution, degree and year completed. Please enter "NA" if there was no secondary education.

Does The Applicant Have Brothers or Sisters?*

Yes
No

Applicant's Brothers and Sisters*

Please include their ages and the schools they attend. If there are no siblings, please type "NA"

Applicant's Special Interests/hobbies:*

Applicant's Favorite Book:*

Applicant's Favorite Subject in School:*

Applicant's Sports or Outdoor Preferences:*

Applicant's Awards or Honors:*

Has the applicant ever had any educational or psychological testing?*

Yes
No

Please explain the circumstances and type of testing.*

If there was none, please type, "NA"

Has the applicant ever been suspended, expelled or asked to withdraw from school?*

Yes
No

Please explain the circumstances surrounding this event.*

If there were no events, please type "NA"

Please describe any family, health, or learning concerns of which Chelsea Academy should be aware.*

If there are none, please type "NA."

How Did You Hear About Chelsea Academy?*

Parent's Signature*

By entering my name in the blank above, I hereby certify this as my official online signature.

Today's Date*

On a separate sheet of paper, describe your child’s particular strengths, weaknesses, and educational background; your hopes for your child; and your reasons for applying to Chelsea Academy.

Upload Parents' Statement*

Applicant’s essay: (1) Describe a person whom you admire and explain why, or (2) describe an achievement or obstacle that you overcame and explain what you learned from the experience. Your essay should be handwritten on a separate sheet of lined paper, and it should not exceed 300 words.

Upload Applicant's Essay*

Non-Refundable Application Fee*

Non-Refundable Application Fee For Chelsea Academy

I understand and agree that this fee is non-refundable and represents my agreement to process this payment through the means I will specify below.

Total

$0.00

Payment Options*

I'd like to pay with my credit card.
I'd like to pay using my PayPal account.

Credit Card

American Express

Discover

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name

Chelsea Academy admits students of any race, color, national and ethnic origin to all the rights, privileges, programs, and activities generally accorded or made available to students at the school. It does not discriminate on the basis of race, color, national and ethnic origin in administration of its educational policies, admissions policies, scholarship and loan programs, and athletic and other school-administered programs.

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