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BACHELOR OF ARTS AND SCIENCES
 
 
PERSONAL INFORMATION
 
  Last Name*
 
  First Name*
 
  Middle Name
 
  Jr., etc.
 
  Female     Male  
 
  Email Address*
 
  Birth Date *   (mm/dd/yyyy)
 
  Permanent Home Address*
 
  City/Town*
 
  State/Province
 
  Country*
 
  Zip/Postal Code*
 
  Permanent Home Phone*
 
  Cell Phone
 
  I am applying for the term beginning January*   (yyyy)
Note: First semester is January 5th – May 15th. Second semester is June 1st – October 15th.
 
In addition to the Four-Cornerstone Curriculum, you may select specialized electives that support your personal goals and/or fulfill the degree requirements for a major. While it is not necessary to declare a major, you may indicate a field of interest here (optional).
                                                                                                                                                                                                        
 
If different from above, please give your mailing address for all admission correspondence.
 
  Mailing Home Address
 
  City/Town
 
  State/Province
 
  Country
 
  Zip/Postal Code
 
  Country of Citizenship*
 
  Other Visas/Residences*
 
The following items are optional. No information you provide will be used in a discriminatory manner.
 
  Place of Birth: City/Town
 
  State/Province
 
  Country
 
  Social Security Number (if any)
 
  First language, if other than English
 
  Primary language spoken at home
 
 If you wish to be identified with a particular ethnic group, please provide a brief
 description of your ethnic background
 
 
 Marital status
 Single     Separated     Married     Widowed    Divorced
 
 
EDUCATIONAL INFORMATION
 
  Secondary school (high school) from which you graduated.*
 
 
  Date of entry*   (mm/dd/yyyy)
 
  Date of secondary graduation*   (mm/dd/yyyy)
 
  Type of School
  Public     Private     Religious     Home school
 
  School Address*
 
  City/Town*
 
  State/Province
 
  Country*
 
  Zip/Postal Code*
 
  Grade Point Average (GPA)*
 
  College or university you now attend.*
 
 
  Date of entry*   (mm/dd/yyyy)
 
  Type of University
  Public     Private     Religious
 
  University Address*
 
  City/Town*
 
  State/Province
 
  Country*
 
  Zip/Postal Code*
 
  Current Grade Point Average (GPA)*
 
Please list all other colleges or universities you have attended for credit, including summer schools and other programs.
 
  Name of College/University 1
 
 
  Location (City, State/Province, Zip/Postal Code, Country)
 
 
  Dates Attended
 
(mm/yyyy - mm/yyyy)  
 
  Degree Candidate  Yes    No Degree(s) Earned
 
  Name of College/University 2
 
 
  Location (City, State/Province, Zip/Postal Code, Country)
 
 
  Dates Attended
 
(mm/yyyy - mm/yyyy)  
 
  Degree Candidate  Yes    No Degree(s) Earned
 
  Name of College/University 3
 
 
  Location (City, State/Province, Zip/Postal Code, Country)
 
 
  Dates Attended
 
(mm/yyyy - mm/yyyy)  
 
  Degree Candidate  Yes    No Degree(s) Earned
 
Please list the names of courses taken and grades earned on a separate document. Please upload this document here.
 
 
 
  Please check the appropriate box:
  Graduated on time/ Will graduate on time
  Graduated early
  Graduated late
  Will not graduate, will receive General Equivalency Diploma (GED)
  Will not graduate, will not receive GED
 
  If you received a GED, list date   (mm/dd/yyyy)
 
 
TEST INFORMATION
 
Please self-report your test scores below. The official scores from the appropriate testing agency may be requested.
 
  ACT
 
  Date taken / to be taken     (mm/dd/yyyy)
 
  English  
 
  Math  
 
  Reading  
 
  Science  
 
  Writing  
 
  SAT
 
  Date taken / to be taken     (mm/dd/yyyy)
 
  Critical Reading  
 
  Math  
 
  Writing  
 
 
  SAT Subject Test
 
  Date taken / to be taken     (mm/dd/yyyy)
 
  Subject  
 
  Score  
 
  Date taken / to be taken     (mm/dd/yyyy)
 
  Subject  
 
  Score  
 
  Date taken / to be taken     (mm/dd/yyyy)
 
  Subject  
 
  Score  
 
  Other Examination
 
  Test Name      
 
  Date taken / to be taken     (mm/dd/yyyy)
 
  Subject  
 
  Score  
 
  Test of English as a Foreign Language (TOEFL) or Other Exams
 
  Test Name  
 
  Date taken / to be taken     (mm/dd/yyyy)
 
  Score  
 
 
FAMILY INFORMATION
 
If you are not a minor, it is not necessary to complete this section.
 
  With whom do you make your permanent home?
Both Parents    Parent/Guardian 1    Parent/Guardian 2    Other  
 
  Parent/Guardian 1: Mother    Father    Legal Guardian
 
  Last Name
 
  First Name
 
  Middle Name
 
  Title (Mr./Mrs./Dr., etc.)
 
  Home address if different from yours
 
  Address
 
  City/Town
 
  State/Province
 
  Country
 
  Zip/Postal Code
 
  Home Phone
 
  Email
 
  Occupation
 
  Name of employer
 
  Parent/Guardian 2: Mother    Father    Legal Guardian
 
  Last Name
 
  First Name
 
  Middle Name
 
  Title (Mr./Mrs./Dr., etc.)
 
  Home address if different from yours
 
  Address
 
  City/Town
 
  State/Province
 
  Country
 
  Zip/Postal Code
 
  Home Phone
 
  Email
 
  Occupation
 
  Name of employer
 
 
ACADEMIC HONORS
 
Briefly list or describe any scholastic distinctions or honors you have earned during secondary school or college (e.g. National Merit, Advanced Placement classes, Dean's List).
 
 
FINANCIAL AID
 
Will scholarships or financial aid be required in order for you to attend The Akademia?
No  Yes
 
Note: In order to apply for scholarships or need-based grants through The Akademia, you must first be admitted to a degree program. If you marked yes to the above question, you will receive a Scholarship and Need-Based Financial Grant Request Form only after admission.
 
 
EXTRACURRICULAR, PERSONAL & VOLUNTEER ACTIVITIES
 
Please list your principal extracurricular, community and family activities and hobbies in the order of their interest to you.
 
  Activity 1
 
  Time Invested
 
  Positions held, honors won or letters earned
  Do you plan to participate in college?
 
  Activity 2
 
  Time Invested
 
  Positions held, honors won or letters earned
  Do you plan to participate in college?
 
  Activity 3
 
  Time Invested
 
  Positions held, honors won or letters earned
  Do you plan to participate in college?
 
 
 
WORK EXPERIENCE
 
Please list the principal jobs you have held during the past two years (including summer employment).
 
  Specific nature of work 1
 
  Employer
 
  Approximate Dates   (mm/yyyy - mm/yyyy)
 
  Approximate Hours Worked Per Week
 
  Specific nature of work 2
 
  Employer
 
  Approximate Dates   (mm/yyyy - mm/yyyy)
 
  Approximate Hours Worked Per Week
 
  Specific nature of work 3
 
  Employer
 
  Approximate Dates   (mm/yyyy - mm/yyyy)
 
  Approximate Hours Worked Per Week
 
 
PERSONAL ESSAY
 
This personal statement helps us become acquainted with you in ways different from courses, grades, test scores and other objective data. It will demonstrate your ability to organize your thoughts and express yourself. We are looking for an essay that will help us to know you better as a person and as a student. Please write an essay (250 words minimum) on one of the topics listed below.
 
1. Evaluate a specific experience, achievement, risk you have taken, or ethical dilemma you have
     faced and its impact on you.

2. Discuss some personal, local, national, or international subject and its importance to you.

3. Indicate a person who has had a significant influence on you, and describe that influence.

4. Describe a character in fiction, a historical figure, or a creative work (as in art, music, science, etc.)
    that has had an influence on you, and describe that influence.

5. Topic of your choice.

Please place your full name on each page of the essay and upload the document here.
 
 
 
 
OTHER INFORMATION
 
Have you ever been found responsible for a disciplinary violation at an educational facility from 9th grade (or international equivalent) forward, whether related to academic misconduct or behavioral misconduct, that resulted in your probation, suspension, removal, dismissal, or expulsion from the institution?
Yes    No
 
Have you ever been convicted of a felony or other serious crime?
Yes    No
 
If you answered yes to either or both questions, please provide the approximate date of each incident and an explanation of the circumstances on a separate document. Please upload this document here.
 
 
 
 
 
Do you enjoy travel? (check one)
Yes    No
 
Would you be comfortable living abroad for at least one academic year?
Yes    No
 
Please provide the location of The Akademia where you wish to attend, if you have a preference. Though we seek to place all students in the location of their choice, it is advisable that you also include at least one alternative location. If you do not have a preference, please leave this field blank .
 
 
  I certify that all information submitted in the admission process – including the application, personal essay and any supporting materials – is my own work, factually true and honestly presented. I understand that I may be subject to disciplinary action, including admission revocation or expulsion, should the information I have certified be false.
 
 
* Required Fields
 
 
 
 
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