Washington Academy 2018-2019 Application for Enrollment
First Name *
Your answer
Middle Name
Your answer
Last Name *
Your answer
Preferred Name
Your answer
Gender *
Date of Birth (mm/dd/yyyy) *
Your answer
Applicant Address
Country *
Home Address *
Your answer
City/Province *
Your answer
State *
Your answer
Zip *
Your answer
Applicant Contact Information
Phone Number *
Your answer
Applicant Email Address *
Your answer
Skype ID (For non-local applicants)
Your answer
Religious Affiliation
Your answer
US Citizen *
Ethnicity (Non US citizens select the "Non-Resident Alien" Selections)
First Language *
Other Language Spoken At Home
Your answer
School Information
Current School
School Name *
Your answer
Current Graduation Year *
School Address
Your answer
City
Your answer
State
Your answer
Zip
Your answer
Country
Principal
Your answer
Core GPA
Your answer
Cumalitive GPA
Your answer
SAT Score (English/Math Score)
Your answer
ACT Score
Your answer
List other high schools (and locations) you have attended

Previous School 1

School Name
Your answer
Location
Your answer
Grade From
Your answer
Grade To
Your answer
Date From (mm/dd/yyyy)
Your answer
Date To (mm/dd/yyyy)
Your answer
Reason Left
Your answer
Previous School 2
School Name
Your answer
Location
Your answer
Grade From
Your answer
Grade To
Your answer
Date From (mm/dd/yyyy)
Your answer
Date To (mm/dd/yyyy)
Your answer
Reason Left
Your answer
Previous School 3
School Name
Your answer
Location
Your answer
Grade From
Your answer
Grade To
Your answer
Date From (mm/dd/yyyy)
Your answer
Date To (mm/dd/yyyy)
Your answer
Reason Left
Your answer
Family Information
Parents Marital Status *
Your answer
Who has legal custody?
Your answer
Who has legal financial responsibility?
Your answer
Who has legal access to academic records and/or behavioral concerns?
Your answer
School correspondence (grade reports) should be sent to
Your answer
Parent/Guardian 1
Please enter information for the applicant's first parent/guardian.

Parent/Guardian 1 Biographical Information

Relationship to applicant *
Your answer
Title *
Your answer
First Name
Your answer
Last Name
Your answer
Lives With Applicant
Use Same Address As Applicant
Address
Your answer
City
Your answer
State
Zip
Your answer
Country
Your answer
Home Phone
Your answer
Cell Phone
Your answer
Email
Your answer
Parent/Guardian 1 Business Information
Employer Name
Your answer
Position/Title
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Address
Your answer
City
Your answer
State
Your answer
Zip
Your answer
Country
Your answer
Parent/Guardian 2
Instructions: Please enter information for the applicant's second parent/guardian.

Parent/Guardian 2 Biographical Information

Relationship to applicant
Your answer
Title
Your answer
First Name
Your answer
Last Name
Your answer
Lives With Applicant
Use Same Address As Applicant
Address
Your answer
City
Your answer
State
Your answer
Zip
Your answer
Country
Your answer
Home Phone
Your answer
Cell Phone
Your answer
Email
Your answer
Parent/Guardian 2 Business Information
Employer Name
Your answer
Position/Title
Your answer
Address
Your answer
City
Your answer
State
Your answer
Zip
Your answer
Country
Your answer
Questions
Describe what motivated you to apply to Washington Academy?
Your answer
Which school subjects do you enjoy most?
Your answer
Which classes are more difficult for you, if any?
Your answer
List sports, school activities or community activities you participate in.
Your answer
List any special learning abilities and/or challenges that you have. (This may include, but not limited to, Gifted and Talented, ADHD, Anxiety, Dyslexia or accommodation plan, etc.)
Your answer
List any medical or health concerns or conditions you may have.
Your answer
List any awards or special accomplishments you have achieved.
Your answer
Link to Highlight Videos and/or Gametapes
Your answer
Sport Requesting to play *
Required
High School Statistics (List whether Freshman, JV, Varsity)
Your answer
Travel Basketball Stats (if applicable)
Your answer
Sports Awards Won
Your answer
Names of brothers and sisters (please include current grade levels and birth dates).
Relationship
Your answer
First Name
Your answer
Last Name
Your answer
Birth Date
Your answer
Current Grade
Your answer
Relationship
Your answer
First Name
Your answer
Last Name
Your answer
Birth Date
Your answer
Current Grade
Your answer
Names and class years of relatives who played college or professional basketball/football.
Your answer
Names of friends or acquaintances who currently attend or attended Washington Academy.
Your answer
Height
Your answer
Weight
Your answer
Vertical Jump
Your answer
40 Yard Time
Your answer
Max Bench
Your answer
Acknowledgement
*I certify that the information presented in my application is accurate, complete, and honestly presented. I also certify that, to the best of my knowledge, any information submitted on my behalf, including letters of recommendation, is authentic. I understand and agree that any intentionally inaccurate information, misleading information, or omission of information will, if discovered at a later date, be cause for recision of any offer of admissions or for dismissal from the school. I also agree to receive Text and Email messages from Washington Academy.
Select to Confirm: *
Required
Parent/Guardian Signature
Signature *
Type Name as Signature
Your answer
Date (mm/dd/yyyy) *
Your answer
Requested Visit Date *Note we fill spots on a first come basis and the later visits may not have spots *
Application Fee
$75.00 for U.S. Resident; $150.00 for Non-U.S. Resident and Residents living outside the continental U.S.; U.S. funds, non-cash, to be supplied with application. This fee is non-refundable.

Mail Check or Money Order to:
Washington Academy Admissions
114 East 3rd Street
Greenville, NC 27858

Credit Card: Pay below or at http://www.washingtonacademync.com/FeePayment.html (click Pay with Debit or Credit Card once you hit Continue on PayPal page) or Call 252-495-8030.

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