Northland Scholars Academy Application Instructions YOUR FUTURE BEGINS HERE! Prior to becoming a Northland Scholars Academy student, you need to first apply NOTE: The application is a PDF format. Make sure you have the most current Acrobat Reader program installed on your computer (see link). It is important to save your document to your computer. We recommend typing and printing one page at time. Step 1: Complete pages 1-3 with personal information and interests: a. Check the line for the program choice (example: School Year-10 months) b. Attach passport-size photo. This can be a passport, school or digital photo c. Include a copy of the picture page of your passport. If you do not have a passport, you will need to apply for one ASAP. Please visit the State Department Website: http://travel.state.gov/passport/fri/pubs/pubs 854.html d. Please be sure to list all food allergies or preferences. Step 2: Complete your Student Letter: Follow the Directions. All letters need to be in English. Remember this is your way of letting us know who you are don t be afraid to be enthusiastic! Step 3: Have your parents complete the Parent letter (in English): This letter, like the Student Letter, is another opportunity to tell us about who you are. This letter will be shared with your residential hall director and your school counselor and should be as detailed as possible Step 4: Complete Parent Family Album: Include as many pages as you would like for your Family Album and be creative! Be sure to include pictures of you and your family and some of the activities you like to participate in. Please label all pictures clearly in English. You can use digital photos or color copies of the originals, provided they do not take away from the quality of the picture. Step 5: Request a written recommendation from your English language teacher (or any teacher for countries without a language requirement): Print out the 1 page recommendation form and give it to your teacher. This section can be completed in pen. The teacher can either give the completed recommendation to you or send it directly to NSA s Student Services office. If they (your teacher) choose to send it directly, have them mail it to the address listed in Step 8. Step 6: Request an official transcript from your high school: An official transcript must have an official school stamp or signature. Step 7: Make a copy of the entire application and keep a copy for your records. W10085 Pike Plains Road, Dunbar, WI 54119 715-324-6900 northlandscholars.org Page 1 of 2
Step 8: We recommend sending the application via e-mail to: admissions@northlandscholars.org As an alternative, applications can be sent via PRIORITY MAIL to: Northland Scholars Academy Student Services W10085 Pike Plains Road Dunbar, WI 54119 We look forward to receiving your application! There is no school application fee. We will review your application and if you meet all of the admission requirements, you and (if applicable) your international agency, will be notified that you have been accepted to Northland Scholars Academy. Our admissions office will send you an Acceptance Letter along with NSA s Authorization Packet. The authorization packet contains all required permission forms which will be needed throughout the school year. All accepted students will receive an Invoice for the tuition, fees, and room and board with payment instructions. Following confirmation of payment received, each student will receive a signed Receipt showing full payment and a zero balance. Each student must take the Acceptance Letter, signed Receipt, the original signed DS2019 from your sponsoring agency, and passport to their local consulate or embassy for the Visa interview. In the event of a cancellation prior to 30 days before the scheduled arrival date, all of the money will be returned except an administrative fee of $300. For more information, contact NSA Admissions by email at admissions@northlandscholars.org Thank you for your interest in attending Northland Scholars Academy, where YOUR FUTURE BEGINS! W10085 Pike Plains Road, Dunbar, WI 54119 715-324-6900 northlandscholars.org Page 2 of 2
NORTHLAND SCHOLARS ACADEMY International Student Application Please type or write in black ink. Program: School Year (10 months) 1st Semester (September-January) 2nd Semester (January-June) Applicant s Nickname: Applicant s family name (as shown on passport) First Name Middle Name Street Address City State/Province Postal Zone/Code Country Home Telephone (with Country/city codes) E-mail Address Fax Number Emergency Contact Name and Telephone Number Country of Legal Residence Nationality on Passport, Passport #/Expiration Date of Birth (month/day/year) Age U.S.A. Emergency Contact Name and Telephone Number City/State or Providence/Country of Birth Gender Male Female Family Information (Please include names, ages and occupations of your family members) Father Mother Sister(s) Brother(s) Religion: Living in household? Yes No Yes Yes Yes No No No How often do you attend services: weekly monthly occasionally holidays never Do you have food allergies? Yes No If yes, please provide details: Do you follow a special diet? Yes No If yes, please indicate: vegetarian kosher Do you have any non-food allergies? Yes No If yes, please describe: other: Have you had any type of work or volunteer experience? Please describe: How many years have you studied English? Slep score: itep SLATE score: Toefl Based internet score: IELTS score: Date of test(s): North Cedar Academy Student Application International Page 1 of 8
Indicate the 5 personality traits which best describe you: PERSONAL INFORMATION Adaptable Friendly Neat Relaxed Shy Athletic Humorous Optimistic Reliable Stubborn Cheerful Independent Organized Reserved Studious Considerate Informal Patient Responsible Talkative Extroverted Intelligent Pessimistic Sensitive Tolerant Flexible Introverted Quiet Serious Traditional Indicate your 5 favorite interests in order of preference by using numbers 1, 2, 3, 4, 5 with 1 being most preferred: Billiards/Pocket Pool Computer Discussing Ideas Music-Classical Singing Board Games/Cards Cooking Discussing Politics Music-Contemporary Social Dating Body Building Crafts Drama/Theater Photography/Video Stamp/Coin Collecting Camping/Backpacking Dance-Ballet Drawing/Painting Playing an Instrument Watching Television Chess/Backgammon Dance-Modern/Jazz Gardening Reading Watching Sports Cinema/Movies Dance-Social Ballroom Museums/Galleries Sewing/Needlework Others List any musical instruments you play: Tell more about the interests you specified above or list other interests not indicated above: I like to meet new people and I want to make many friends. Indicate your 5 favorite sports in order of preference by using 1,2,3,4,5 with 1 being most preferred: U.S. Football Field Hockey Horseback Riding Sailing Tennis Badminton Fishing Hunting Roller Skating Track/Running Baseball Golf Ice Hockey Snow Skiing Volleyball Basketball Gymnastics Ice Skating Soccer Water Skiing Bicycling Hiking Martial Arts Swimming Windsurfing Tell more about the level of your participation and/or achievements in the sports listed above or list other sports not indicated above: Do you hope to participate in sport(s) while attending Northland Scholars Academy? No Yes If yes, which sport? North Cedar Academy Student Application International Page 2 of 8
Describe your hometown: PERSONAL INFORMATION continued What are your favorite family times (what you look forward to doing with them)? What are the family guidelines (rules) of your household? What happens when the rules are broken? What are your household responsibilities at home? Describe any part-time jobs or work experience you may have had and/or any volunteer activities you have participated in. Is there a volunteer activity you might be interested in doing? Are you a member of any clubs/organizations? If yes, please specify. What are you most proud of? Describe your best friend. What qualities make him/her your friend? How do you deal with peer pressure? North Cedar Academy Student Application International Page 3 of 8
STUDENT LETTER This letter is an important part of your application. It is an opportunity for you to introduce yourself to your school. You should make your letter as friendly and personal as possible. To accomplish this you may want to share your hopes, fears, likes and dislikes, etc. You should try to avoid repeating information you have already provided elsewhere in the application. Be creative and let your personality show! In an effort to ensure the letter s copy quality, please TYPE or clearly PRINT in BLACK INK. Your letter is limited to the space below. Please write or type within the space provided below. The STUDENT LETTER is to be written by YOU, IN ENGLISH with no assistance. North Cedar Academy Student Application International Page 4 of 8
PARENT LETTER Your letter is an important part of your student s application. Without repeating any of the information provided elsewhere in this application, please present detailed information which may help everyone at NSA to understand your child s personality, interests, lifestyle, and habits. We ask that you be frank and honest and comment on your child s strengths and weaknesses. Please include the type of information that you would want to know if you were going to host or be responsible for someone else s child. In an effort to ensure the letter s copy quality, please TYPE or clearly PRINT in BLACK INK. Your letter is limited to the space below. Please write or type within the lines that are provided below. North Cedar Academy Student Application International Page 5 of 8
FAMILY ALBUM On these next two pages insert recent photos showing you, your family, and your friends in the places you frequent, doing things you enjoy, and every day activities. It is our intention that these photos will help us at NSA to better get acquainted with you. Place A Family Photo Here Describe the photo above: Place A Photo of a Family Activity Here Describe the photo above: North Cedar Academy Student Application International Page 6 of 8
FAMILY ALBUM continued On these two pages insert recent photos showing you, your family, and your friends in the places you frequent, doing things you enjoy, and every day activities. It is our intention that these photos will help us at NSA to better get acquainted with you. Place A Friend Photo Here Describe the photo above: Place a Photo of a Family or Friend Activity Here Describe the photo above: North Cedar Academy Student Application International Page 7 of 8
ENGLISH TEACHER S RECOMMENDATION Student s name: Teacher s name Teacher s signature School name Street address City State/Province Country At least one recommendation from an English teacher is required. Additional teacher recommendations may be submitted on a separate sheet, noting the teacher s school and title (i.e., History Teacher) and addressing the questions listed below. How long have you known the applicant? (Recommendations should be from an English teacher who has known the applicant for at least one year) Rate applicant s written and spoken English proficiency: Reading Writing Speaking Understanding Advanced Good Fair Poor Does the applicant possess the maturity and academic motivation to live and study in the United States for a year/semester? Please provide any supporting information on why or why not. Describe the applicant s interpersonal skills with peers and teachers. What are the applicant s strengths and weaknesses? Please explain in detail. Please use the other side of this form to provide additional comments that may assist us in evaluating the applicant s qualifications. North Cedar Academy Student Application International Page 8 of 8