Student Photo

Please attach the most recent school photo of your student via this file upload or send one in the mail.

Max file size: 10 MB

Date of Birth (mm/dd/yyyy)

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.

First Namerequired

Last Name

Relationship to Student

Please use lower case only.

Primary Phone

Please use numbers only; no special characters.

Parent/Guardian 2 Information

Primary Phone

Please use numbers only; no special characters.

Relationship to Student

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

With whom does the student applicant live?

Parents' Marital Status

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.

Applicant's current school

School Phone

Please use numbers only; no special characters.

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

Name

Please list the first and last name.

Subject and Grade Level

Please use lowercase only.

Address, City, State, ZIP

Phone

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

Name

Please list the first and last name.

Subject and Grade Level

Please use lowercase only.

Address, City, State, ZIP

Phone

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

Name

Please list the first and last name.

Subject and Grade Level

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?*

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

Name of Relative 2

Relationship to Applicant

Name of Relative 3

Relationship to Applicant

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.

Attach File

Max file size: 10 MB

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 Scholar Competition participants are exempt from this fee.

Select One*

Applying to Grades 9 -12 $35 application fee Fee Waived (Malone Scholar, Canterbury Scholar, Middle School Scholar Participants)

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