Re Brent International School Manila Student Information Application for Admission Full Legal Name: Nickname: Last name First name Middle Name Current Grade: Male Female Applying for admission grade, entering in of 20. Religion: Month year optional Are you a returning Brent Student? No Yes What grades and years did you attend Brent? Is this your first application Brent? No Yes Current School s Curriculum: [ ] IB [ ] British [ ] American [ ] Philippines Other Date of Birth: Month Day Year Age: Citizenship/Passport: Country of Birth: Residential Address in the Philippines: Mailing Address in the Philippines for correspondence: [ ] Same as residential address above. If not please provide: Mailing Address in the Philippines for billing: [ ] Same as residential address above. If not please provide: Home Phone Fax Languages Spoken: 1 st 2 nd 3 rd Student will: [ ] commute by private car [ ] walk [ ] take the school bus: Area Personal Hisry Has your child skipped a grade? no yes What grade/s? Has your child ever been in a gifted program? no yes What grade/s? Has your child ever been retained (repeated a grade)? no yes What grade/s? Has your child had any specific learning difficulties? no yes If yes, please provide details: Has your child received extra help in school? no yes If yes, please describe: Has your child ever been enrolled in a Learning Support Program? no yes If yes, please provide details: Has your child ever had an Individual Educational Plan (IEP)? no yes Please provide a copy Has your child ever had a psycho-educational evaluation? no yes Please provide a copy of the full report Does your child have any emotional issues? no yes If yes, please elaborate: 11
Does your child have any physical disabilities/impairments? no yes If yes, provide details: Does your child have any medical conditions? no yes If yes, provide details: Has your child had counseling for personal or emotional difficulties? no yes If yes, please elaborate: Has your child recently received any English language support (ESL) at school? no yes If yes, please provide details: English Language Proficiency Complete if English is NOT the first language of the student. Applicants grades 9-12 must be fluent be accepted. SKILLS Fluent Strong, but needs improvement in reading/writing Some abilities; limited Beginner Reading Writing Speaking Listening (understanding) Scholastic Information Applicant s current, or most recent, school: Website: School Address: Head of School, Name and Email: Grade Levels Attended: Last Grade Completed: Last month/year attended: / School s Calendar Months start / end Name of school/s attended Country Dates attended month/year month/year Age of applicant (Age) 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 Name of grade level, or year Language of instruction 12
If the applicant has been attending school, what is the reason for changing schools? Is the applicant eligible remain, or return, their most recently attended school? yes no If not, why? Did the applicant pass all subjects during the last grading period? yes no Subject/s failing are: Has the applicant ever received disciplinary action in a former school? yes no Detention: Suspension: Please state reason/s: How long does the applicant intend study at Brent? Honors, Awards and Outstanding Achievements (team captain, class president, role in a play, etc ) Student Interests (check all that apply) art / design computers drama outreach soccer volleyball badminn cooking drawing phography student council yearbook band creative writing film studies reading singing Other: baseball cross country golf robotics swimming basketball dance Lego rugby taekwondo chess debate orchestra school magazine tennis Please comment on any special talents your child has: Foreign Passport Holders Upon acceptance, the Admissions office will provide the family with information from the office of the President and CEO regarding visas. The family will need complete and submit the forms prior the first day of school. Brent International School Manila has all the support necessary help with any visa issues, but it is very important submit the documents in a timely manner so that the student can start attending classes. 13
Parent Information Father Stepfather Mr. Mother Stepmother Ms. Dr. Atty. Other Mrs. Dra. Other Father Full Name Citizenship (Passport) Phil. Visa Category Religion (optional) Home Address (if different from applicant) Home Telephone Cell Phone # Occupation / Title Company Name Company Address Work Phone Work Fax # Email address Mother Parental Status Check where applicable: (if the description does not apply your family, please adjust the wording.) Parents Married Applicant Adopted Single Parent Father Deceased Mother Deceased Parents Separated Father Remarried Mother Remarried Parents Divorced Applicant Lives With (Philippines): Father and Mother Father Mother Stepfather/Mother Stepmother/Father Please indicate who is responsible: for school-related decisions Father Mother receive school correspondences Father Mother Sponsoring Organization/Company If school fees are be paid by an employer, please submit a letter that effect on the employer s letterhead. A Guarantee Payment Letter template is available from Admissions. Organization name: Address: Contact person: Email: Telephone: Fax: Siblings Name Age Grade level School Applying Brent? (yes/no/enrolled) 14
Permission for Drug Testing (For grade 6 and above) We believe a healthy educational environment is a drug-free environment. Our philosophy at Brent International School Manila centers on prevention and education with regards the use of drugs, bacco, and alcohol. Further, we believe the majority of our students choose not use these substances, and we want reinforce those positive decisions whenever and wherever possible. We also recognize, however, that teenage peer pressure can be profound. We therefore believe strongly in an education and detection system that enables our young people stay drug free throughout their years at Brent and beyond. To assist our students with their decisions and enable them make positive choices where drugs are concerned, we will conduct random urinalysis of our students from time time. We ask your cooperation as a parent in consenting these tests when we deem them necessary and when your child is selected. Parents will be notified of the results of all urinalysis testing. Our intention for students who test positive is that drug treatment / intervention will be provided. Subsequent positive tests after rehabilitation, however, may be grounds for dismissal of that student from Brent. Refusal sign this permission document by the parent may also constitute grounds for dismissal of the student from Brent International School Manila. I give Brent International School Manila permission conduct drug tests (urinalysis) as they deem necessary. Applicant s Signature (if grade 6+) Parent s Signature (If child is grade 6+) Date Agreement The parent signature below constitutes agreement with the following: 1. It is required that at least one parent must legally reside and live with the student in the Philippines; guardians are not allowed. 2. It is required that the student s parent/s should notify the school for any change in contact information of the student. 3. The student and the parent/s will abide by the school s established policies and procedures. 4. The student s parent/s understand that students, when at school on school property, when taking or boarding the Brent school bus and from their homes or on organized field trips, are supervised by staff members and/or other responsible adults who will exercise all reasonable caution. However, student s parent/s agree that the school and its members cannot accept any liability for accidents or incidents which may occur either at school or en route and from school during the student s participation in Brent school field trips or bus service. 5. It is the responsibility of the student s parent/s ensure that students are covered with the current and comprehensive health insurance during their time at Brent School. Should an accident occur on school property or during a school-related event, the school s liability will not exceed Php 50,000.00. 6. The student s parent/s grants permission Brent Schools Inc. use the student s phos in print or digital promotions for the school, as well as on its website. 7. Families need communicate with Brent Schools Inc. regarding legal documentation, when applicable. Foreign passport holders will complete and submit the required forms the Office of the President and CEO regarding visas prior the first day of school. 8. Understanding the Christian ecumenical environment at Brent, and that there is an established Brent curriculum that all students experience, I am aware that my child will attend a weekly assembly that includes a chapel portion, and that a religion course is required in most grade levels. 9. The student s parent/s have provided information without omissions or falsification and provided all supporting documents complete the application. In the event that it is revealed that the student s parent/s deliberately falsified or omitted information, Brent School reserves the right withdraw at anytime an enrolled student. 10. I authorize Brent School contact this applicants former school/s for the purpose of obtaining and/or verifying student records. Parent Name, Printed Signature Date 15
Attach a recent passport size phograph here # 1 of 4 Attach a recent passport size phograph here # 2 of 4 Attach a recent passport size phograph here # 3 of 4 For Admissions Office use For School ID For Registrar s Office use 16