School Placement Form

Student Personal Information
Full Name in English: *
Full Name in English:
Date of Birth: *
Date of Birth:
Family Information
Father's or Guardian's Full Name in English: *
Father's or Guardian's Full Name in English:
(If different from student)
Mother's or Guardian's Full Name in English: *
Mother's or Guardian's Full Name in English:
(If different from student)
Academics
Entry Date: *
Entry Date:
Graduation Date: *
Graduation Date:
(Predicted)
List All Previous Secondary Schools
Include summer schools you have attended (as well as summer and other programs)
(City, State, Country / Date Attended (from: mm/yyyy to: mm/yyyy))
Academics, Colleges & Universities
List all Colleges/Universities at which you have taken courses for credit (For University Applicants ONLY)
(City, State, Country / Date Attended (from: mm/yyyy to: mm/yyyy))
Standardized TESTS
(IF YOU HAVE TAKEN ANY OF THE FOLLOWING TESTS, PLEASE SELF-REPORT YOUR SCORES BELOW)
(Total Score, Listening Score, Reading Score, Writing Score, Speaking Score and Date of Examination)
(Overall Band Score, Listening Score, Reading Score, Writing Score, Speaking Score and Date of Examination)
(Total/ Composite Score, English Score, Mathematics Score, Science Score, Reading Score, Writing Score and Date of Examination)
(Total Score, Evidence-Based Reading & Writing Score, Mathematics Score and Date of Examination)
Please Specify
High School Program Information
(For High School Applicants Only)
Requested Start Date:
Requested Start Date:
Have you ever been on a Student Visa?
(In USD)
Specific schools/ districts or requests such as location, budget, sports, arts, etc
University Program Information
(For University Applicants Only)
Future Plans
Entry Date:
Entry Date:
Entry Term:
AMBITIONS & DEGREE PLACEMENT
Degree: I am interested in pursuing a:
ACADEMIC MAJORS/ AREAS OF FOCUS
PLEASE RATE THE IMPORTANCE OF THE FOLLOWING FACTORS:
PLEASE RATE THE IMPORTANCE OF THE FOLLOWING FACTORS:
Do you think that this factor is very important when you're considering for university?
Financial Cost
Location
Campus Setting
Academics
Athletics
Religious Affiliation
PLEASE IDENTIFY YOUR PREFERENCES BELOW:
Please provide your budget in USD per year
Campus Setting
Athletics
Religious Affiliation
THANK YOU FOR COMPLETING THE School placement FORM!

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