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OFFICE OF ADMISSIONS
333 Forest Street, Waltham, MA 02452 Phone: 781.642.6800 Email: [email protected] www.gannacademy.org
GANN ACADEMY APPLICATION FOR ADMISSION
Applicants: Thank you for applying to Gann Academy. Please complete this form and attach a recent photograph of yourself. STUDENT INFORMATION Applying for grade
o 9 o 10 o 11 Gender__________
DOB (MM/DD/YYYY) _________ /________ /_________
Student Name ________________________________________________________________________________________________ Nickname ___________________________________________________________________________________________________ Home Phone _______________________Student Cell Phone_______________________Student Email_________________________ Street Address_________________________________________________________________________________________________ City _________________________________ State ________________________________ Zip________________________________ Country of Birth _______________________ US Citizen
o Yes
o No
Non-US Country of Citizenship__________________
Current School _____________________________________________________________ Years Attended_______________________ Previous Schools ___________________________________________________________ Years Attended_______________________ ____________________________________________________________ Years Attended______________________ ____________________________________________________________ Years Attended______________________ EXTRACURRICULAR ACTIVITIES AND SUMMER EXPERIENCES Please list your extracurricular activities below. Please note which you intend to continue. Attach an additional piece of paper if needed. Activity
Organization
Year(s) Involved
Intend to Continue? Yes/No Yes/No Yes/No Yes/No
How have you spent the last three summers? If you attended a camp, please include the camp name. ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________
OFFICE OF ADMISSIONS
333 Forest Street, Waltham, MA 02452 Phone: 781.642.6800 Email: [email protected] www.gannacademy.org
GANN ACADEMY APPLICATION FOR ADMISSION FAMILY INFORMATION Parent/Guardian 1
Relationship:
o Mother
o Father
o Stepparent
o Grandparent
Other ______________________
Title ______________ Last Name_________________________ First Name__________________________ Middle Initial________ Parent Cell Phone _____________________________________Parent Email_______________________________________________ Occupation ____________________________Employer ___________________________Work Phone__________________________ o Check here if address is the same as applicant’s address. If different, please complete below. Street Address_________________________________________________________________________________________________ City __________________________________State___________ Zip________________ Home Phone_________________________ Parent/Guardian 2
Relationship:
o Mother
o Father
o Stepparent
o Grandparent
Other _____________________
Title ______________ Last Name_________________________ First Name__________________________ Middle Initial________ Parent Cell Phone _____________________________________Parent Email_______________________________________________ Occupation ____________________________Employer ___________________________Work Phone__________________________ o Check here if address is the same as applicant’s address. If different, please complete below. Street Address_________________________________________________________________________________________________ City __________________________________State___________ Zip________________ Home Phone_________________________
To whom should correspondence be sent?
Parents are
o Single
o Married
o Parent/Guardian 1
o Separated
o Divorced
o Parent/Guardian 2
o Both
o Widowed
Additional Stepparent/Legal Guardian Name ________________________Relationship_____________________________________ Additional Stepparent/Legal Guardian Name ________________________Relationship_____________________________________
OFFICE OF ADMISSIONS
333 Forest Street, Waltham, MA 02452 Phone: 781.642.6800 Email: [email protected] www.gannacademy.org
GANN ACADEMY APPLICATION FOR ADMISSION FAMILY INFORMATION Other Children in Family Name
Date of Birth
Grade/Year
Current School or College
________________________________ ___________________ _____________________ __________________________________ ________________________________ ___________________ _____________________ __________________________________ ________________________________ ___________________ _____________________ __________________________________ Grandparents Name
Address
Phone
_______________________________ _______________________________________ ___________________________________ _______________________________ _______________________________________ ___________________________________ _______________________________ _______________________________________ ___________________________________ _______________________________ _______________________________________ ___________________________________
Has any family member attended Gann Academy?
o Yes
Name
o No
Relationship
____________________________________________________ _______________________________________________________ ____________________________________________________ _______________________________________________________ ____________________________________________________ _______________________________________________________ FAMILY’S JEWISH INVOLVEMENT
Do you belong to a synagogue or independent minyan? o Yes
o No
If yes, which? ________________________________________________________________________________________________
Are there other Jewish or civic organizations that are important to your family? Please list. ___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________
OFFICE OF ADMISSIONS
333 Forest Street, Waltham, MA 02452 Phone: 781.642.6800 Email: [email protected] www.gannacademy.org
GANN ACADEMY APPLICATION FOR ADMISSION Applicants will not be discriminated against in the admissions process for applying for financial aid. Will you be applying for Financial Aid?
o Yes
o No
Please return your completed form with a $100 non-refundable application fee to the Office of Admissions by January 15. Checks should be made payable to Gann Academy.
We understand that, in addition to this form, we must submit additional completed items, as indicated on the Application Checklist. Only upon receipt of these items and an interview with an admissions officer will an applicant be considered for admission to Gann Academy.
Student Signature ________________________________________________________________ Date__________________________
Parent/Guardian Signature _________________________________________________________ Date__________________________
Parent/Guardian Signature _________________________________________________________ Date__________________________
Completed application materials should be submitted to the Office of Admissions via mail or email: Gann Academy Office of Admissions 333 Forest Street Waltham, MA 02452 Email: [email protected] Questions? Please contact the Office of Admissions at 781-642-6800.
333 Forest Street, Waltham, MA 02452 Phone: 781.642.6800 Email: [email protected] www.gannacademy.org
GANN ACADEMY APPLICATION FOR ADMISSION
Applicants: Thank you for applying to Gann Academy. Please complete this form and attach a recent photograph of yourself. STUDENT INFORMATION Applying for grade
o 9 o 10 o 11 Gender__________
DOB (MM/DD/YYYY) _________ /________ /_________
Student Name ________________________________________________________________________________________________ Nickname ___________________________________________________________________________________________________ Home Phone _______________________Student Cell Phone_______________________Student Email_________________________ Street Address_________________________________________________________________________________________________ City _________________________________ State ________________________________ Zip________________________________ Country of Birth _______________________ US Citizen
o Yes
o No
Non-US Country of Citizenship__________________
Current School _____________________________________________________________ Years Attended_______________________ Previous Schools ___________________________________________________________ Years Attended_______________________ ____________________________________________________________ Years Attended______________________ ____________________________________________________________ Years Attended______________________ EXTRACURRICULAR ACTIVITIES AND SUMMER EXPERIENCES Please list your extracurricular activities below. Please note which you intend to continue. Attach an additional piece of paper if needed. Activity
Organization
Year(s) Involved
Intend to Continue? Yes/No Yes/No Yes/No Yes/No
How have you spent the last three summers? If you attended a camp, please include the camp name. ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________
OFFICE OF ADMISSIONS
333 Forest Street, Waltham, MA 02452 Phone: 781.642.6800 Email: [email protected] www.gannacademy.org
GANN ACADEMY APPLICATION FOR ADMISSION FAMILY INFORMATION Parent/Guardian 1
Relationship:
o Mother
o Father
o Stepparent
o Grandparent
Other ______________________
Title ______________ Last Name_________________________ First Name__________________________ Middle Initial________ Parent Cell Phone _____________________________________Parent Email_______________________________________________ Occupation ____________________________Employer ___________________________Work Phone__________________________ o Check here if address is the same as applicant’s address. If different, please complete below. Street Address_________________________________________________________________________________________________ City __________________________________State___________ Zip________________ Home Phone_________________________ Parent/Guardian 2
Relationship:
o Mother
o Father
o Stepparent
o Grandparent
Other _____________________
Title ______________ Last Name_________________________ First Name__________________________ Middle Initial________ Parent Cell Phone _____________________________________Parent Email_______________________________________________ Occupation ____________________________Employer ___________________________Work Phone__________________________ o Check here if address is the same as applicant’s address. If different, please complete below. Street Address_________________________________________________________________________________________________ City __________________________________State___________ Zip________________ Home Phone_________________________
To whom should correspondence be sent?
Parents are
o Single
o Married
o Parent/Guardian 1
o Separated
o Divorced
o Parent/Guardian 2
o Both
o Widowed
Additional Stepparent/Legal Guardian Name ________________________Relationship_____________________________________ Additional Stepparent/Legal Guardian Name ________________________Relationship_____________________________________
OFFICE OF ADMISSIONS
333 Forest Street, Waltham, MA 02452 Phone: 781.642.6800 Email: [email protected] www.gannacademy.org
GANN ACADEMY APPLICATION FOR ADMISSION FAMILY INFORMATION Other Children in Family Name
Date of Birth
Grade/Year
Current School or College
________________________________ ___________________ _____________________ __________________________________ ________________________________ ___________________ _____________________ __________________________________ ________________________________ ___________________ _____________________ __________________________________ Grandparents Name
Address
Phone
_______________________________ _______________________________________ ___________________________________ _______________________________ _______________________________________ ___________________________________ _______________________________ _______________________________________ ___________________________________ _______________________________ _______________________________________ ___________________________________
Has any family member attended Gann Academy?
o Yes
Name
o No
Relationship
____________________________________________________ _______________________________________________________ ____________________________________________________ _______________________________________________________ ____________________________________________________ _______________________________________________________ FAMILY’S JEWISH INVOLVEMENT
Do you belong to a synagogue or independent minyan? o Yes
o No
If yes, which? ________________________________________________________________________________________________
Are there other Jewish or civic organizations that are important to your family? Please list. ___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________
OFFICE OF ADMISSIONS
333 Forest Street, Waltham, MA 02452 Phone: 781.642.6800 Email: [email protected] www.gannacademy.org
GANN ACADEMY APPLICATION FOR ADMISSION Applicants will not be discriminated against in the admissions process for applying for financial aid. Will you be applying for Financial Aid?
o Yes
o No
Please return your completed form with a $100 non-refundable application fee to the Office of Admissions by January 15. Checks should be made payable to Gann Academy.
We understand that, in addition to this form, we must submit additional completed items, as indicated on the Application Checklist. Only upon receipt of these items and an interview with an admissions officer will an applicant be considered for admission to Gann Academy.
Student Signature ________________________________________________________________ Date__________________________
Parent/Guardian Signature _________________________________________________________ Date__________________________
Parent/Guardian Signature _________________________________________________________ Date__________________________
Completed application materials should be submitted to the Office of Admissions via mail or email: Gann Academy Office of Admissions 333 Forest Street Waltham, MA 02452 Email: [email protected] Questions? Please contact the Office of Admissions at 781-642-6800.
