Student Information

Contact Information

Parent or Guardian Phone

Vital Statistics

Religious Background

Family Data

Answer the questions that follow, then fill out a "Parent or Guardian" section for each parent or guardian in your family (Father, mother, stepfather, stepmother, or other guardian). Leave any remaining "Parent or Guardian" section blank.

Parent or Guardian 1
Parent or Guardian 2

Academic Information

Academic History

List all the schools you have attended, including correspondence schools, beginning with the eighth grade. List the school name, address, dates of attendance, classes taken, and grade received.

Learning & Emotional Info

Student contract - To be completed by applicant

Parent or guardian contract - To be completed by the parent or guardian of the applicant

Additional parents or guardians

Spiritual Interest

Musical interest

Media & Hobbies

Work Ethic

Interest in Laurelbrook

Short responses

Respond in one or two sentences what these statements mean to you, regarding each of the following unique aspects of Laurelbrook listed below.

Statements of honesty and accuracy

Parent or guardian