Personal Information:

Name:  Age:    Grade Level:

Address:    City:  

State:   Zip Code:

Phone Numbers (include area code):     Cell Phone:

Names of Parent(s) or Guardian(s):

Other Contact Information (Names and phone numbers of relative or guardian other than your
parents):
 

How Many Persons are in Your Household?

Are you in need of financial assistance for tuition at Gateway Academy?  Yes    No

What after school activities are you involved in?

Do you have a job? Yes    No     
If so, where, and how many hours a week?

Educational History

Where do you currently study?  

What are your current classes?

What are the titles and authors of the last three books you have read?

How many hours a week (outside of school) do you spend reading?
 

Essay Section: Write a short paragraph or two on each of these questions:
1. Which teacher has inspired you the most, and why?



2. What is your favorite book, and why?

3. Why do you want to attend Gateway Academy?