EmailMe Form - International Student Online Application

Student Legal Name: *

First Middle Last

Prefers to be called: *

Date of Birth: *

MM / DD / YYYY

Gender: *

Male

Female

St. Mary's International F-1 Program of Interest: *

One-Year Program

SMHS Diploma Program

Students choosing to enroll in our ONE-YEAR academic program are choosing to learn more about American culture while also taking strong academic courses for credits that will transfer back to their high school transcript in their own country.

St. Mary’s High School’s DIPLOMA Program is open to qualifying I-20 students. St. Mary’s, a college-prep Catholic high school, provides an opportunity to graduate from an American high school by fulfilling all graduation requirements and earning a St. Mary’s diploma. This program’s intent is to prepare and place international students into the American college of their choice upon high school graduation. Students receive individual assistance with testing, college applications, and available academic scholarships.

Qualified Student: Language Test required, overall scores required: TOEFL(50 or above), or IELTS(6 or above), or ELTiS (225 or above); Current Transcript grades will be reviewed.

Length of Planned Stay: *

Semester

1 Year

2 Years

3-4 Years

Current Grade: *

Senior 12th

Junior 11th

Sophomore 10th

Freshman 9th

Applying to St. Mary's for Grade: *

Senior 12th

Junior 11th

Sophomore 10th

Freshman 9th

International Agency representing student (List None if not using one): *

Local Representative working with host family representing agency or parents:

Students must live with an immediate family relative or agency-sponsored host family. A LOCAL COORDINATOR is REQUIRED when school is contacted to find a host family. There is a fee for this service. SMHS can provide one if needed; parent will pay fee directly to coordinator. (If you are with an agency, they will provide the local coordinator fee in your contract.)

Student's HOME Address: *

Province/City: *

Country: *

Zip: *

Address for I-20 to be mailed: *

If I-20 needs to be addressed to an address different than the home address above, please provide

PARENT INFORMATION

Parent 1: *

First Last

Relationship: *

Mother

Father

Comment

Email: *

Do not add a space after email address.

Cell Phone # *

Occupation:

Place of employment: *

Parent 2:

First Last

Relationship:

Mother

Father

Comment

Email:

Do not add a space after email address.

Occupation:

Place of employment:

EMERGENCY CONTACT INFORMATION

In Case of Emergency:
(NOT parents) *

First Last

Relationship: *

In Case of Emergency phone: *

### - ### - ####

STUDENT MEDICAL INFORMATION

Please list any medical needs, allergies, required medication or diagnosed medical conditions, such as Diabetes, Seizure Activity, Asthma, Attention Deficit Disorder (ADD) and/or Attention Deficit Hyperactivity Disorder (ADHD), etc.
If NONE, state "NONE".

Student Medical Information: *

Student's Insurance (insured by whom): *

STUDENT QUESTIONNAIRE

How did you hear about St. Mary's High School? *

Are any of your classes taught in English only? If so, which class(es)? *

Are you currently taking an English class? What are some novels that you have recently read? *

Name some activities in which you are currently involved. *

PHOTO RELEASE:

I give SMHS Administration or their delegate the right to use photographs, and any other materials in which the student may appear, for promotional or publicity of future programs.

Parent Signature: *

ACADEMIC SCHEDULE:

I understand and support SMHS Administration's right to make the final decision in my student's scheduled courses based on his/her transcripts and language test scores which I have provided.

Parent Signature: *

SURVEY OF STUDENT INTEREST IN SPORTS
(optional)

There are 3 sport seasons in high school in Colorado: Fall, Winter, Spring. If you are interested in participating in a sport, please indicate below.

FALL SPORTS:

WINTER SPORTS:

Basketball (boys)

Basketball (girls)

Swimming & Diving (girls)

Wrestling (boys)

SPRING SPORTS:

Please upload student's transcripts and/or completed application.

Photo:

Transcripts:

Language Test Scores: (TOEFL, IELTS, ELTiS)

Visa/Passport:

Immunization Records:

Teacher Recommendations:

Insurance/ Temporary Guardianship:

Agency Use Only: Upload Student's Application

Parent Signature: *

With my typed name on this line, I, the parent/guardian, agree that the information provided above is truthful and complete. I understand that if any information given is incomplete or inaccurate, it may affect my student's admission, acceptance and/or enrollment at St. Mary's High School. I understand that additional information, beyond what is required in the initial Admissions Application, may be requested by SMHS in order to complete the Admissions process.

Parent Signature: *

I understand by my signature/mark that enrollment of my student at St. Mary's High School indicates my acceptance of the rules and regulations set forth in the St. Mary's High School Family Handbook.

The Handbook can be viewed on our school website at http://www.smpirates.org.

Today's Date: *

MM / DD / YYYY

TUITION CONTRACT (please go to link below)

https://www.emailmeform.com/builder/form/44e9ftZRd63d5D0eCI25aMn

Parent's Signature *

I understand by my signature/mark that the Tuition Contract must be signed and submitted before my Student can be officially enrolled and classes scheduled. (An invoice can be provided if needed)
I am also aware of set deadlines for Tuition payment and that failure to meet these deadlines could result in my student's dismissal.

Tuition Invoice *

Please email me an invoice.

I do not need an invoice.

Invoice will be mailed to parent's email address. (Agencies will always receive an invoice emailed to agent who is working with SMHS).

PARENT INFORMATION

EMERGENCY CONTACT INFORMATION

STUDENT MEDICAL INFORMATION

STUDENT QUESTIONNAIRE

PHOTO RELEASE:

ACADEMIC SCHEDULE:

SURVEY OF STUDENT INTEREST IN SPORTS (optional)

TUITION CONTRACT (please go to link below)

SURVEY OF STUDENT INTEREST IN SPORTS
(optional)