MIDDLE DIVISION APPLICATION
M I D D L E D I V I S I O N A P P L I C AT I O N
M I D D LE D IVIS ION APPLI C ATION FOR G R A D E S 6 – 8 Families and prospective students for Middle Division admission should complete the following applications. Once completed, please separate the applications from the instructions and mail the forms to: D I R E CTO R O F AD M I S S I O N S, B E R K E LEY P R E PARATO RY S C H O O L, 4 811 K E LLY R OAD, TAM PA, F L 33 615
D E A D LIN E
B E R K E LE Y TE S TING & W R ITING SA M PLE
The Middle Division Admissions Committee begins evaluation of completed
In addition to the SSAT, all applicants for grades 6-8 should schedule an
application files in mid-January with notification on a rolling basis from the
appointment with the Admissions Office for the OLSAT (Otis-Lennon
end of January until all vacancies are filled. Capacity enrollment is usually
School Ability Test) and a writing sample at Berkeley. Available dates are
achieved by early March with later applications considered for waiting pool
included.
status. Parent Application: January 30 Student Application: January 30
VIS ITS TO B E R K E LE Y Students and families are invited to visit for a campus tour and/or Open House. Student tour guides are available Monday through Friday between
INS TRU C TIONS FOR C O M PLE TING APPLI C ATION Parent/Guardian to complete the Parent Application Applicant to complete Student Application (May come by separate cover) Attach a copy of the applicant’s birth certificate, his/her photograph
8:00 a.m. and 2:00 p.m. Please call the Admissions Office for information and appointments. Students may also attend classes for a partial day by shadowing a current Berkeley student. These arrangements must be made in advance, as space is limited.
(optional, but encouraged) and the $75.00 application fee. Sign Permission for School to Release Student Records, located on School Recommendation Checklist, and deliver to applicant’s current school after
FE E S
the first grading period. This recommendation should be completed by a
A non-refundable application fee of $75.00 is required.
language arts or math teacher, signed by the principal or head of school
If a student is accepted for admission, the parents will be sent enrollment
and forwarded directly to the Admissions Office along with a transcript
instructions. In order to secure a place, the contract and appropriate
of grades and test scores. A return envelope is provided for your school’s
deposit should be completed by the date indicated. This deposit is the first
convenience.
payment of the yearly tuition. The remaining payments are due in July, August, September, October, November, December and January.
S E C ON DARY S C HOOL A D M IS S IONS TE S T (S SAT ) All applicants for grades 6–8 should take the SSAT as early as possible,
FIN AN C IAL AI D
preferably in November, December or January. The applicant’s family is
For more information regarding the financial aid process, please refer to
responsible for individual registration. Please refer to the enclosed SSAT
the insert or visit us at www.berkeleyprep.org/tuitionandfinancialaid.
information pamphlet or visit www.ssat.org. When registering, please select Berkeley (school code 1600) as a score recipient.
Thank you for your interest in Berkeley Preparatory School. We look forward to seeing you. For more information visit our website at www.berkeleyprep.org
G RA D E 6–8 PAR E NT AP P L I CATI O N Please submit by January 30th with the $75.00 application fee. APPLI C ANT ’ S N A M E (Last, First, Middle, & Prefers to be called)
Home Address City State
Zip
Date of Birth Place of Birth Gender Citizenship
E THNI C IT Y (Optional)
African American
Caucasian
Middle Eastern
Multiracial
Asian American
Latino/Hispanic
Native American
Other
R E LIG ION (Optional) Primary language spoken in the home Applicant for admission to the
(grade) beginning August
(year)
Has the applicant applied to Berkeley previously? If so, when?
What grades, if any have been skipped or repeated?
PR E S E NT S C HOOL
School Address
School Phone ( ) Headmaster / Principal Present Grade Number of years attended
FOR M E R S C HOOL S (List in order, most recent first.) Dates Attended
School Name Address
Dates Attended
School Name Address
Has the applicant applied to other schools?
Yes
No
Please list other schools where applications have been filed.
PAR E NT/GUAR D IAN 1 Full Name (Dr./Mr./Mrs./Ms.) Cell Telephone ( Home Address (if different from applicant’s) Home Telephone (
) )
Occupation / Title Business Telephone (
)
Employer Preferred Email Business Address College and Degrees
PAR E NT/GUAR D IAN 2 Full Name (Dr./Mr./Mrs./Ms.) Cell Telephone ( Home Address (if different from applicant’s) Home Telephone (
) )
Occupation/Title Business Telephone (
)
Employer Preferred Email Business Address College and Degrees Parents/Guardians are
Married
Divorced
Separated
Single Parent
Mother Deceased
Father Deceased
Mother Remarried
Father Remarried
If you anticipate requesting financial aid, please check. A financial aid information packet will be mailed to you after November 1.
All admission correspondence will be sent to the applicant’s home address unless otherwise noted.
1
S IBLINGS Name Birthdate
School
Name Birthdate
School
Name Birthdate
School
R E L ATIV E S who attend or have attended Berkeley Preparatory School Name Years Attended
Date of Graduation
Relationship
Name Years Attended
Date of Graduation
Relationship
How did you hear about Berkeley?
PA R E N T/G UA R D I A N S IG N ATUR E S I/We agree to support and abide by School regulations and guidelines not only at the time of admission but also throughout subsequent years of attendance. All enrollments are for the entire school year. I/We authorize Berkeley Preparatory School to contact current and previous schools and other sources to obtain information to support this application. I/We will not seek access to confidential recommendations and evaluation materials before or after the admissions decision is made. Signature of Parents/Guardians
PA R E N T/G UA R D I A N S TATE M E NT (Re quired) Please tell us anything that might help the Admissions Committee better understand your child.
S PE C IAL C IR CU MS TAN C E S Please provide any information which would assist us in working with your child.
Has the applicant ever been subject to disciplinary action, suspension or dismissal from previous schools?
Yes
No
Explanation
Failure to answer honestly may negate this application. Berkeley Preparatory School admits students of any race, gender, color, religion, national or ethnic origin and does not discriminate on the basis of any of these categories or any other category protected by law in the administration of its educational policies, admissions policies, scholarship and loan programs, athletic and other school administered programs.
2
G RA D E 6–8 ST U D E NT AP P LI CAT I O N
INS TRU C TIONS The purpose of this form is to help Berkeley
become acquainted with the student. Therefore, this application form is to be filled out by the applicant himself or herself in his/her own handwriting (unless completed online). Please use blue or black ink. A recent photograph is requested.
Date Application for Grade To Enter: Fall Term
Photo (Optional, but encouraged)
N A M E
Address
City State Zip Telephone Email Parents / Guardians’ Names Parent / Guardian 1
Address Parent / Guardian 2
Address Present School Telephone
Present Counselor or Teacher
I . AC A D E M I C S A. What
is/are your favorite subject(s)?
B. In
your opinion what are the qualities of a good teacher?
C. What
books have you read recently?
D. Do
you regularly read magazines, newspapers or online publications, and if so, which ones?
3
II . E X TR ACUR R I CUL AR AN D C O M M UN IT Y INTE R E S TS AN D AC TIVITIE S A. What
are your favorite sports and why?
B. In
what sports do you expect to participate for Berkeley and why?
C. Please
indicate your interest in fine arts.
Art (drawing, painting, sculpture, etc.)
Music (instruments, choir, etc.)
Drama (plays, etc.) D. What
are your hobbies?
E. To
what clubs or organizations do you belong?
F. Other
Interests
G. Do
you feel it is possible to participate in multiple extra-curricular activities and still excel in the classroom? Explain
III . PE RSON AL IN FOR M ATION A. How
do you usually spend your summers?
Camp Summer School Travel Other
4
III . PE RSON AL INFOR M ATION (C ONTINU E D) B. How
do you spend your free time on weekends?
C. Do
you know any students who attend Berkeley? If so, who?
D. Have
you ever been subject to disciplinary action, suspension or dimissal from previous school(s)?
E. Is
there anything else you would like to tell us about yourself?
5
4 8 1 1 K E L LY R OAD, TAM PA, F L 3 3 6 1 5
pho ne 8 1 3 . 8 8 5 . 1 673
fax 813.886.6933
w w w. b e rk e l e y p re p . o rg
M I D D LE D IVIS ION APPLI C ATION FOR G R A D E S 6 – 8 Families and prospective students for Middle Division admission should complete the following applications. Once completed, please separate the applications from the instructions and mail the forms to: D I R E CTO R O F AD M I S S I O N S, B E R K E LEY P R E PARATO RY S C H O O L, 4 811 K E LLY R OAD, TAM PA, F L 33 615
D E A D LIN E
B E R K E LE Y TE S TING & W R ITING SA M PLE
The Middle Division Admissions Committee begins evaluation of completed
In addition to the SSAT, all applicants for grades 6-8 should schedule an
application files in mid-January with notification on a rolling basis from the
appointment with the Admissions Office for the OLSAT (Otis-Lennon
end of January until all vacancies are filled. Capacity enrollment is usually
School Ability Test) and a writing sample at Berkeley. Available dates are
achieved by early March with later applications considered for waiting pool
included.
status. Parent Application: January 30 Student Application: January 30
VIS ITS TO B E R K E LE Y Students and families are invited to visit for a campus tour and/or Open House. Student tour guides are available Monday through Friday between
INS TRU C TIONS FOR C O M PLE TING APPLI C ATION Parent/Guardian to complete the Parent Application Applicant to complete Student Application (May come by separate cover) Attach a copy of the applicant’s birth certificate, his/her photograph
8:00 a.m. and 2:00 p.m. Please call the Admissions Office for information and appointments. Students may also attend classes for a partial day by shadowing a current Berkeley student. These arrangements must be made in advance, as space is limited.
(optional, but encouraged) and the $75.00 application fee. Sign Permission for School to Release Student Records, located on School Recommendation Checklist, and deliver to applicant’s current school after
FE E S
the first grading period. This recommendation should be completed by a
A non-refundable application fee of $75.00 is required.
language arts or math teacher, signed by the principal or head of school
If a student is accepted for admission, the parents will be sent enrollment
and forwarded directly to the Admissions Office along with a transcript
instructions. In order to secure a place, the contract and appropriate
of grades and test scores. A return envelope is provided for your school’s
deposit should be completed by the date indicated. This deposit is the first
convenience.
payment of the yearly tuition. The remaining payments are due in July, August, September, October, November, December and January.
S E C ON DARY S C HOOL A D M IS S IONS TE S T (S SAT ) All applicants for grades 6–8 should take the SSAT as early as possible,
FIN AN C IAL AI D
preferably in November, December or January. The applicant’s family is
For more information regarding the financial aid process, please refer to
responsible for individual registration. Please refer to the enclosed SSAT
the insert or visit us at www.berkeleyprep.org/tuitionandfinancialaid.
information pamphlet or visit www.ssat.org. When registering, please select Berkeley (school code 1600) as a score recipient.
Thank you for your interest in Berkeley Preparatory School. We look forward to seeing you. For more information visit our website at www.berkeleyprep.org
G RA D E 6–8 PAR E NT AP P L I CATI O N Please submit by January 30th with the $75.00 application fee. APPLI C ANT ’ S N A M E (Last, First, Middle, & Prefers to be called)
Home Address City State
Zip
Date of Birth Place of Birth Gender Citizenship
E THNI C IT Y (Optional)
African American
Caucasian
Middle Eastern
Multiracial
Asian American
Latino/Hispanic
Native American
Other
R E LIG ION (Optional) Primary language spoken in the home Applicant for admission to the
(grade) beginning August
(year)
Has the applicant applied to Berkeley previously? If so, when?
What grades, if any have been skipped or repeated?
PR E S E NT S C HOOL
School Address
School Phone ( ) Headmaster / Principal Present Grade Number of years attended
FOR M E R S C HOOL S (List in order, most recent first.) Dates Attended
School Name Address
Dates Attended
School Name Address
Has the applicant applied to other schools?
Yes
No
Please list other schools where applications have been filed.
PAR E NT/GUAR D IAN 1 Full Name (Dr./Mr./Mrs./Ms.) Cell Telephone ( Home Address (if different from applicant’s) Home Telephone (
) )
Occupation / Title Business Telephone (
)
Employer Preferred Email Business Address College and Degrees
PAR E NT/GUAR D IAN 2 Full Name (Dr./Mr./Mrs./Ms.) Cell Telephone ( Home Address (if different from applicant’s) Home Telephone (
) )
Occupation/Title Business Telephone (
)
Employer Preferred Email Business Address College and Degrees Parents/Guardians are
Married
Divorced
Separated
Single Parent
Mother Deceased
Father Deceased
Mother Remarried
Father Remarried
If you anticipate requesting financial aid, please check. A financial aid information packet will be mailed to you after November 1.
All admission correspondence will be sent to the applicant’s home address unless otherwise noted.
1
S IBLINGS Name Birthdate
School
Name Birthdate
School
Name Birthdate
School
R E L ATIV E S who attend or have attended Berkeley Preparatory School Name Years Attended
Date of Graduation
Relationship
Name Years Attended
Date of Graduation
Relationship
How did you hear about Berkeley?
PA R E N T/G UA R D I A N S IG N ATUR E S I/We agree to support and abide by School regulations and guidelines not only at the time of admission but also throughout subsequent years of attendance. All enrollments are for the entire school year. I/We authorize Berkeley Preparatory School to contact current and previous schools and other sources to obtain information to support this application. I/We will not seek access to confidential recommendations and evaluation materials before or after the admissions decision is made. Signature of Parents/Guardians
PA R E N T/G UA R D I A N S TATE M E NT (Re quired) Please tell us anything that might help the Admissions Committee better understand your child.
S PE C IAL C IR CU MS TAN C E S Please provide any information which would assist us in working with your child.
Has the applicant ever been subject to disciplinary action, suspension or dismissal from previous schools?
Yes
No
Explanation
Failure to answer honestly may negate this application. Berkeley Preparatory School admits students of any race, gender, color, religion, national or ethnic origin and does not discriminate on the basis of any of these categories or any other category protected by law in the administration of its educational policies, admissions policies, scholarship and loan programs, athletic and other school administered programs.
2
G RA D E 6–8 ST U D E NT AP P LI CAT I O N
INS TRU C TIONS The purpose of this form is to help Berkeley
become acquainted with the student. Therefore, this application form is to be filled out by the applicant himself or herself in his/her own handwriting (unless completed online). Please use blue or black ink. A recent photograph is requested.
Date Application for Grade To Enter: Fall Term
Photo (Optional, but encouraged)
N A M E
Address
City State Zip Telephone Email Parents / Guardians’ Names Parent / Guardian 1
Address Parent / Guardian 2
Address Present School Telephone
Present Counselor or Teacher
I . AC A D E M I C S A. What
is/are your favorite subject(s)?
B. In
your opinion what are the qualities of a good teacher?
C. What
books have you read recently?
D. Do
you regularly read magazines, newspapers or online publications, and if so, which ones?
3
II . E X TR ACUR R I CUL AR AN D C O M M UN IT Y INTE R E S TS AN D AC TIVITIE S A. What
are your favorite sports and why?
B. In
what sports do you expect to participate for Berkeley and why?
C. Please
indicate your interest in fine arts.
Art (drawing, painting, sculpture, etc.)
Music (instruments, choir, etc.)
Drama (plays, etc.) D. What
are your hobbies?
E. To
what clubs or organizations do you belong?
F. Other
Interests
G. Do
you feel it is possible to participate in multiple extra-curricular activities and still excel in the classroom? Explain
III . PE RSON AL IN FOR M ATION A. How
do you usually spend your summers?
Camp Summer School Travel Other
4
III . PE RSON AL INFOR M ATION (C ONTINU E D) B. How
do you spend your free time on weekends?
C. Do
you know any students who attend Berkeley? If so, who?
D. Have
you ever been subject to disciplinary action, suspension or dimissal from previous school(s)?
E. Is
there anything else you would like to tell us about yourself?
5
4 8 1 1 K E L LY R OAD, TAM PA, F L 3 3 6 1 5
pho ne 8 1 3 . 8 8 5 . 1 673
fax 813.886.6933
w w w. b e rk e l e y p re p . o rg
