* Required

Application Type*

High School High School Transfer Junior Academy

I. Student Information

First Namerequired

Last Namerequired

Preferred First Name

Student Email

Student Cell Phone

Birth Date (mm/dd/yyyy)required

Current Graderequired

Grade Applying Torequired

Current Schoolrequired

Number of Years Attending Current Schoolrequired

Public School Districtrequired

Assigned Public Schoolrequired

Other Schools Attended in Last Three Yearsrequired

Religionrequired

Church/Place of Worshiprequired

II. Parent/Guardian Information

Is either parent deceased?*

Yes No

Name(s)

If deceased, when?

Parental Status*

Married Separated Divorced Never Married

Household 1 (Primary Address for Student)

Is this household financially responsible for the student?*

Yes No

Does this household have custody of the student?*

Yes No

Address Line 1required

Address Line 2

Cityrequired

Staterequired

ZIP Coderequired

Parent/Guardian 1 (Household 1)

Title/Prefix

First Name

Last Name

Cell Phone

Occupation

Employer

Parent/Guardian 2 (Household 1)

Title/Prefix

First Name

Last Name

Cell Phone

Occupation

Employer

Does the student have a second household? (Secondary Address for Student)*

Yes No

Household 2 (Secondary Address for Student)

Is this household financially responsible for the student?

Yes No

Does this household have custody of the student?

Yes No

Address Line 1

Address Line 2

City

State

ZIP Code

Parent/Guardian 1 (Household 2)

Title/Prefix

First Name

Last Name

Cell Phone

Occupation

Employer

Parent/Guardian 2 (Household 2)

Title/Prefix

First Name

Last Name

Cell Phone

Occupation

Employer

III. Family Information

How many?

Younger Sisters

Older Sisters

Younger Brothers

Older Brothers

Please list names of sisters:

Sister 1 Name

Sister 1 Age

Sister 1 Current School

Sister 2 Name

Sister 2 Age

Sister 2 Current School

Sister 3 Name

Sister 3 Age

Sister 3 Current School

Please list names of siblings/relatives who are attending or who have attended SUA:

Name

(include maiden name if applicable)

Class Year

Relationship to Student

Name

(include maiden name if applicable)

Class Year

Relationship to Student

Name

(include maiden name if applicable)

Class Year

Relationship to Student

IV. Additional Student Information

Is your daughter currently enrolled in a gifted education program? *

Yes No

Please explain:required

Please list any health concerns or physical limitations.required

Is your daughter currently on an IEP, 504, MAP, or Service Plan?*

Yes No

Please note you will need to provide a copy of your daughter's IEP, 504, MAP, or Service Plan, and ETR with supplemental application materials.

Has your daughter ever had attendance or discipline issues?*

Yes No

Please explain:required

Is your daughter applying to multiple schools?*

Yes No

Please name other school(s) applying to:required

V. JA Parent Questionnaire

Please share any special qualities, talents, or athletic/artistic abilities your daughter possesses.required

What are you seeking in a school for your daughter?required

Describe your involvement in your daughter's education.required

V. Transfer Questionnaire

What extracurricular activities, both athletic and non-athletic, are of interest to the student?required

Parent Question: Why would you like your daughter to attend SUA? Please include any comments concerning health, physical limitations, or learning disabilities.required

Student Question: Why do you want to transfer to SUA?required

Please send a confirmation email to the address below*: