High School Application

General Information

Today's Date

Must contain a date in M/D/YYYY format

For what school year are you applying?

Entering Graderequired

Student Applicant Information

First Namerequired

Middle Name

Last Name

Nickname

Date of Birth

Must contain a date in M/D/YYYY format

Gender

Male

Female

Student Email

If applicable, please enter the student's email address using all lower case.

Family's Preferred Phone

Please use numbers only; no special characters.

Student's Address 1

City

State

Zip

Country

Family Information

Your Information

Prefix

First Namerequired

Last Name

Suffix

Relationship to Student

Email

Please use lower case only.

Primary Phone

Please use numbers only; no special characters.

Address

City

State

Zip

Country

Job Title

Employer

Parent/Guardian 2 Information

Prefix

First Name

Last Name

Suffix

Email

Primary Phone

Please use numbers only; no special characters.

Relationship to Student

Address

City

State

Zip

Country

Job Title

Employer

Sibling Information

Please list the name(s) and age(s) of this student's sibling(s).

With whom does the student applicant live?

Parents' Marital StatusCheck all that apply

Parents are married

Parents are divorced

Parents are separated

One or both parents are remarried

One or both parents are single

NA

Check all that apply

If parents are separated/divorced, which parent will assume financial responsibilty for the applicant?

Do you plan to apply for financial aid?

Yes

No

Ethnicity (Optional)

We collect this information for statistical and reporting purposes. It is entirely optional.

Ethnicity

African American

Asian American

Caucasian/European American

Latino/Hispanic American

Middle Eastern American

Multiracial American

International Student

Other

School Information

Applicant's current school

Current Grade

School Address

City

State

Zip

Country

School Phone

Please use numbers only; no special characters.

References

Please list names of teachers you have asked to provide academic references.

Reference 1

Name

Please list the first and last name.

Subject and Grade Level

Email

Please use lowercase only.

Address, City, State, ZIP

Phone

Please include the area code. Use numbers only; no special characters.

Reference 2

Name

Please list the first and last name.

Subject and Grade Level

Email

Please use lowercase only.

Address, City, State, ZIP

Phone

Please include the area code. Use numbers only; no special characters.

Reference 3

Name

Please list the first and last name.

Subject and Grade Level

Email

Please use lowercase only.

Address, City, State, ZIP

Phone

Please include the area code. Use numbers only; no special characters.

Additional Information

Are you a 21st Century Scholar?required

Yes

No

Has this student applicant applied to Canterbury School before?

Yes

No

When did this student apply to Canterbury School?

Has this student applicant visited Canterbury School before?

Yes

No

When did this student visit Canterbury School?

Did someone recommend Canterbury School to you?

Yes

No

Who recommended Canterbury School to you?

Do you have any relatives who have attended Canterbury School?

Yes

No

Please list any relatives who have attended Canterbury School.

Name of Relative 1

Relationship to Applicant

Date of Attendance

Name of Relative 2

Relationship to Applicant

Date of Attendance

Name of Relative 3

Relationship to Applicant

Date of Attendance

Why have you chosen to apply?

List sports, hobbies, musical, artistic or other talents of the applicant and his/her time commitment to them.

If applicant requires special accommodations, please identify them.

If applicant has had aptitude/achievement testing or diagnostic evaluation other than at school, please attach the file or enclose a copy with your application fee, or indicate where we may write for full information

What would you like the admissions director to know that has not been covered in this application?

Application Fee and Payment

This application is a statement of parental intent, not a contract. A formal contract must be signed after the applicant is accepted for admission. This application is not considered complete until the applicant has been tested and interviewed by the school.

Grade 9 -12 Applications: A non-refundable $35 fee must be submitted with the application

Malone Scholars Program participants and Canterbury Scholastic Competition participants are exempt from this fee.

Select Onerequired

Applying to Grades 9 -12 $35 application fee ($35.00)

Fee Waived (Malone Scholar, Canterbury Scholastic Competition)

General Information

Student Applicant Information

Family Information

Your Information

Parent/Guardian 2 Information

Sibling Information

Ethnicity (Optional)

School Information

References

Reference 1

Reference 2

Reference 3

Additional Information

Application Fee and Payment

Payment Information