Application For Admission

Student Information

Name:
Last Name
First Name
Middle
Prefer to be called
Sex
MaleFemale
Date of Birth
Skype ID
WeChat ID
Phone
Email
Address:
Street
City
State
Zip
Country
Presently In Grade
Applying for Grade
Applying for Fall 20
Applied to MPS before
YesNo
Applied to PIA before
YesNo
Citizen Of
Native Language
Language Spoken At Home
Current Immigration Status
U.S. CitizenU.S. Resident(Green Card)I require an I-20 for my student visa
I have an I-20 issued by
How did you find out about Mercyhurst Preparatory School (MPS)?
List any friends/relatives who have attended MPS(name, class, relationship)
Are you working with an Education Consultant?
YesNo
If yes, Please provide the Name of Consultant
Phone Number
Who is financially responsible?
MotherFatherBothOther
If Other
Father's Name
Cell Phone
Email Address
Mothers's Name
Cell Phone
Email Address

School Information

Name of Last School Student Attended
Address
School Street
City
State/Province
Zip Code
Country
Phone Number
School Type
ParochialIndependant/PrivatePublic
Please list all schools student attended in the last four years and the dates of attendance
If student was in an accelerated program, please list any grades skipped
Grades which student has repeated:
How would student describe his/her attitude toward school and learning?
Please rate student’s academic work from previous years
ExcellentGoodAveragePoor
Has student ever had any disciplinary difficulties, either at home or in school?
YesNo
If Yes, please explain
Has student ever had any extended or frequent absences from school?
YesNo
If Yes, please explain
Please describe any physical restrictions, learning disabilities, learning differences, special accommodations or social limitations we should know about regarding the student
Sports in which the student would like to participate (www.mpslakers.com)
Fall
Winter
Spring
Previous Sports Team Experience

WRITTEN RECOMMENDATION INFORMATION

Please include a written letter of recommendation from the Math and English teachers with boarding application.
Written Recommendation

 
Facebook Us!