Excelsior Preparatory School admissions

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Excelsior Artz Preparatory School believes that diversity offers students a plethora of learning experiences that will be helpful when they enter the global workforce and the University of Life. We do not discriminate against any individual based on race, gender, or ethnicity. We believe in giving all students equal access to a top-notch education.

Please review our admissions process and checklist of required items prior to completing the admissions application. 

NOTE: Questions flagged with (*) are required

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Admission Application

Student Information

Student's Name*
Student's full name is required

Student's Date of Birth (mm/dd/yyyy)*
Please enter students Date Of Birth in the format mm/dd/yyyy

Gender*
Please select student's gender

Last 4 digits of Social Security #*
Last 4 digits of your student's Social Security # is required

Birth Certificate Number*
Student's Birth Certificate Number is required

Date of Last Immunization*
Please select the date of your student's last immunization

Date of Last Physical Examination*
Please select the date of your student's last physical examination

Primary Physician's Name*
Please enter your Primary Physician's Name

Primary Physician's Phone Number *
Please enter Primary Physician's Telephone Number

Address*
Student's Home Address

City*
Please enter City

State / Region*
State is required

Zipcode*
Zipcode is required

Name of last school student attended *
Name of last school student attended is required

Last School's Phone Number
Please enter a valid phone number

Parent's Name (Mother)*
Mother's name is required

Parent's Name (Father)*
Father's name is required

Last Grade Level*
Please enter the last grade at Student's last school

Promoted*
Was the student promoted?

(Upload academic transcripts, such as report cards and standardized tests at the end of this form prior to submission)

Were special educational services ever provided to your child? (If yes, please explain)*
Please respond to question

Has your child ever received school counseling due to behavioral issues?*
Please select Yes or No

Who does the child listed above live with? (Check all that apply)*
Please select one

Child lives with other (Please explain)
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Family Information: Mother

Is Mother Employed*
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Mother's Work Place*
Please enter mother's workplace

Mother's Occupation*
Please enter Mother's Occupation

Mother's Work Phone
Please enter Mother's Work Phone

Mother's Address*
Please enter mother's street address

City*
Please enter Mother's City

State / Region*
Please enter mother's state

Zipcode*
Please enter a valid zipcode

Mother's Home Phone Number*
Please enter Mother's phone number

Mother's Cell Phone Number*
Please enter Mother's cell phone number

Family Information: Father

Is Father Employed*
Is Father Employed?

Father's Work Place*
Please enter father's workplace

Father's Occupation*
Please enter Father's Occupation

Father's Work Phone
Please enter Father's Work Phone

Is Father's address the same as Mother's?*
Please select yes or no

Father's Address*
Please enter father's street address

City*
Please enter Father's City

State / Region*
Please enter Father's state

Zipcode*
Please enter a valid zipcode

Father's Home Phone Number*
Please enter Father's phone number

Father's Cell Phone Number*
Please enter Father's cell phone number

 
Is your student entering grades 6 to 8?*
Please select Yes or No

Excelsior Artz Preparatory School Student Questionnaire - Grades (6-8)

What is your favorite academic subject?*
Please respond to question

What subject least interests you?*
Please respond to question

What does God mean to you?*
Please respond to question

How much time do you spend after school to complete homework and study?*
Please respond to question

What special traits do you want your teacher and classmates to know about you?*
Please respond to question

What are your goals for this upcoming school year, and how can your teacher help you to accomplish them?*
Please respond to question

Which student clubs below interest you most? (Check two to three boxes only.)*

Please respond to question

What chores are you responsible for at home?*
Please respond to question

What do you enjoy doing with your leisure time?*
Please respond to question

Excelsior wants to help develop students’ minds and strengthen their character in an effort to lead them along a path of success. In order to accomplish this goal, students must help us by cooperating with school rules, policies, and procedures. Have you read the Student Discipline Code/Policy? Do you agree to comply with the rules listed in it?

I have read the Student Discipline Code/Policy*
Please confirm that you have read the Student Discipline Code/Policy

Student's Name - Electronic Signature*
Please enter your name, it will serve as your signature

 

Authorization for Release of Records

Please send the following documents for the named student to Excelsior Artz Preparatory School by uploading below (.pdf, .doc, .docx only) or Fax to 1-888-924-1197

Academic Transcript Upload
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Report Card Upload
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Standardized Test Scores
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Specialized Testing Results, Including Psychological Evaluation and/or IEP if applicable
Invalid Input

Student Health Examination Record
Invalid Input

Certification of Immunization
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I herby authorize the release of the aforementioned records to Excelsior Artz Preparatory School.

Parent's Name*
Please enter parent's name

Today's Date*
Please select today's date

Parent's Email*
Please enter a valid email address

Parent's Phone Number*
Please enter parent's phone number

Federal Law 99.21- No parent signature is required for educational records to be released to another educational agency. Thank you for your prompt attention to this matter.

Respectfully,

Kayann Baugh-Toney
Superintendent

*
Please enter the two words in the box above