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St. Andrew Academy Student Application Form
Student Information
First Name
*
Last Name
*
MI
Address 1
*
Address 2
Phone
Email Address
City
*
State
*
Zip Code
*
Marital Status
*
Married
Separated
Divorced
Domestic Partners
Single Parent
Unmarried
Residence Status
*
US Citizen
US Permanent Resident
International Student
Current Residential Housing Situation
*
Rent a house or apartment
Live in a house or apartment with family
Live in group home with others
Other / Comments - Please describe below:
Other / Comments - Please describe below:
Transportation Needs to Academy Location in Livonia Michigan
*
I will arrange my own transportation to the Academy
I will use public transportation to the Academy
I need arranged transportation to the Academy
I need financial assistance with transportation to the Academy
Other / Comments - Please describe below:
Other / Comments - Please describe below:
Are Any Physical Accomodations Needed?
*
Mobility: Handicap Access to Facility / Wheelchair Ramp
Low Vision: Need Screen Reader or other Visual Accomodation
Audio: Closed Captions and American Sign Language Interpreter
Visual Handicap: Need Braille and All Text to Audio Translation
None
Other - please describe below:
Other - please describe below:
Religious Affiliation
*
Are you a currently registered with Michigan Rehabilitation Services?
*
Yes
No
Academic Background: High School / Secondary School
High School Name
*
City
*
State
*
GPA
*
Any Advanced Placement Classes (please list)
*
Please list any awards or honors that you have received.
*
Academy Background: Higher Education
University or Community Colleg Name
*
City
*
Declared Academy Major or Academy Focus (if not formally declared)
*
Degree Earned
*
Grade Point Average
*
Years / Terms Completed
*
No Higher Education Completed
0-1 Year or 1-2 Academic Terms Completed
1-2 Years or 3-4 Academic Terms Completed
3-4 Years or 5-6 Academic Terms Completed
5-6 Years or 7-8 Academic Terms Completed
Other - please describe below:
Other - please describe below:
Religious Affiliation / Interest
Religious Affiliation
*
Judaism
Catholic
Christianity (non-Catholic)
Islam
Hinduism
Buddhism
Atheist
None
Other - Please describe below
Other - Please describe below
Catholic Sacraments completed (check all that apply)
Baptism
Eucharist
Reconciliation
Confirmation
Not applicable / non Catholic
Other (please describe)
Other (please describe)
Primary Parish, Church or Synagogue Name
*
City
State
I am Interested in the Spiritual Growth Program as part of this Academy?
*
Yes
No
Employment History
Previous Employment History (please list with most recent jobs first):
Employer
Position
Start and End Dates
Most Recent
Employer
Position
Start and End Dates
Previous 1
Employer
Position
Start and End Dates
Previous 2
Employer
Position
Start and End Dates
Other Information
Please list any sports, extracurricular, or community service activities you regularly participate in.
Why are you interested in the IT training and certification program?
*
Why are you interested in the Christian Faith enrichment (Faith Pathways) program?
*
Please list any leadership roles you have had
Resume or Background Summary: Please Upload Here
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