MONTEVERDE FRIENDS SCHOOL - STUDENT APPLICATION FORM 2008

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5655 Monteverde, Puntarenas - Costa Rica, America Central
Phone/Fax: 011-506-645-5302
E-mail: mfschool@racsa.co.cr

STUDENT APPLICATION FORM 2008–2009
Student Application for applicants grades K–12
A $30 application fee must accompany the completed form.

Date of aplication:

_____________

Term applied for :

_____________

Expected grade level:

_____________

Full name:

____________________________________________

Birth date:

_____________

Gender:

_____________

Cedula or passport n°:

____________________________________________

We need a copy of the birth certificate or a copy of the passport

Mother’s / Guardian’s full name:

____________________________________________

Father’s / Guardian’s full name:

____________________________________________

Parent / Guardian’s home phone:

_____-_______________

Parent / Guardian’s work phone:

_____-_______________

E-mail address:

_____________________

Address in the U.S.:

____________________________________________

City:

_____________

Zip Code:

_____________

Address in Monteverde:

____________________________________________

Schools attended in 2006-2007:

____________________________________________

Schools attended previously:

Year: _______-_______________________________

If the student is transferring from another school, his/her transcript should be sent. High School students also need to submit 2 letters of recommendation from teachers from the previous year.
See: High School Recommendation Form

Year: _______-_______________________________

Which languages does the student:

Speak? _____________________________________

Read? ______________________________________

Write? ______________________________________

How well? ___________________________________

Language of his/her preference:

At home: ____________________________________

Second: _____________________________________

Third: ______________________________________

Please describe anything we should know about your son/daughter?
Special needs, learning difficulties, neurological diagnosis, history which could affect learning, etc.

_________________________________________________________________________

What are your reasons for registering your child at the Monteverde Friends School?

1.________________________________________________________________________

2.________________________________________________________________________

3.________________________________________________________________________

What is your family’s religious preference? How do you understand Quaker religious practice in relation to your own religion?

_________________________________________________________________________

Have you read the mission statement of the school? Are you in agreement with the mission statement? Can you actively support it?

_________________________________________________________________________

Have you discussed with your son or daughter the expectations of behavior, cooperation, academic effort, and attendance (including attending Meeting for Worship)?

_________________________________________________________________________

Do you understand the expectations for parent participation in the school?

_________________________________________________________________________

TUITION AGREEMENT Check the appropriate response
____	We will pay regular tuition (listed in Parent Responsibility Statement)
____	We can sponsor another student at : $ _________ for the year.
____	We need financial aid: The scholarship committee will send a form which must be completed and returned by 03/31/04

AGREEMENT

With our signature below we affirm that we register: ________________________________________ in the Monteverde Friends School, and furthermore

We agree to take part in the activities and responsibilities of the Parents as described in this application and in the Family Manual. We will fulfill our obligations, including attending teacher conferences and meetings.
We accept the obligation to pay the full year’s tuition for our son/daughter, less any scholarship we may receive. We understand that we must pay the full year even if we withdraw our son/daughter before the end of the year (whether the withdrawal is our decision, or the school’s for academic or behavioral reasons). Exception is made for health reasons (a letter from the doctor is required) or if the family leaves the zone for reasons of employment (the parents should write a letter to the director explaining the circumstances). We also understand that failure to make timely payments without previous arrangements may mean financial penalties or withdrawal of our son/daughter from school.
We are in agreement with the School Mission Statement and understand the rules and the attendance requirements for students. We agree to support the school both in academic expectations as well as supporting the spiritual and moral goals of the school. We have explained to the student his/her academic responsibilities, attendance requirements (including Worship), and responsibilities toward staff and students.

Father or guardian's signature:	____________________________________________
Cedula or passport n°:	____________________________________________
Mother or guardian's signature:	____________________________________________
Cedula or passport n°:	____________________________________________
Application dated:	____________________ Monteverde, Puntarenas

IN CASE OF EMERGENCY
How can we reach you in case of emergency?	_______________________________
If we can’t reach you, who can we call? Name:	_______________________________
Emergency phone:	_____-_______________
Indicate any health problems the applicant has:
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
Does she/he take any medicines regularly? If so, which ones?
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
Does she/he have any allergies? If so, to what?
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
In case of minor pain: Check the option you prefer:

____	When our child has a headache or other minor pain, we would like him/her to be given acetaminophen. (In the event of repeated problems, call us.)
____	When our child has a headache or other minor pain , we want to be called and consulted as to what to do.

PERMISSION
We give permission to the staff of Monteverde Friends School to: give first aid or other medical attention in case of emergency and to supervise his or her discipline and behavior at school and during school-sponsored and school-related activities.

Father or guardian's signature:	____________________________________________
Mother or guardian's signature:	____________________________________________

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