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BACHELOR OF ARTS AND SCIENCES |
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| PERSONAL INFORMATION |
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| Last Name* |
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| First Name* |
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| Middle Name |
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| Jr., etc. |
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| Female |
Male |
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| Email Address* |
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| Birth Date * |
(mm/dd/yyyy) |
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| Permanent Home Address* |
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| City/Town* |
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| State/Province |
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| Country* |
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| Zip/Postal Code* |
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| Permanent Home Phone* |
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| Cell Phone |
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| I am applying for the
term beginning January* |
(yyyy) |
| Note: First semester is January 5th – May 15th. Second semester is June 1st – October 15th. |
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| 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). |
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If different from above, please give your mailing address for all admission correspondence. |
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| Mailing Home Address |
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| City/Town |
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| State/Province |
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| Country |
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| Zip/Postal Code |
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| Country of Citizenship* |
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| Other Visas/Residences* |
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The following items are optional. No information you provide will be used in a discriminatory manner. |
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| Place of Birth: City/Town |
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| State/Province |
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| Country |
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| Social Security Number (if any) |
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| First language, if other than English |
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| Primary language spoken at home |
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If you wish to be identified with a particular ethnic group, please provide a brief description of your ethnic background |
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| Marital status |
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Single
Separated
Married
Widowed
Divorced
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EDUCATIONAL INFORMATION |
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| Secondary school (high school) from which you graduated.* |
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| Date of entry* |
(mm/dd/yyyy) |
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| Date of secondary graduation* |
(mm/dd/yyyy) |
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| Type of School |
Public
Private
Religious
Home school
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| School Address* |
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| City/Town* |
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| State/Province |
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| Country* |
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| Zip/Postal Code* |
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| Grade Point Average (GPA)* |
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| College or university you now attend.* |
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| Date of entry* |
(mm/dd/yyyy) |
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| Type of
University |
Public
Private
Religious
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| University Address* |
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| City/Town* |
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| State/Province |
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| Country* |
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| Zip/Postal Code* |
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| Current Grade Point Average (GPA)* |
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Please list all other colleges or universities you have attended for credit, including summer schools and other programs. |
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| Name of
College/University
1 |
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| Location (City, State/Province, Zip/Postal Code, Country) |
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| Dates Attended |
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| (mm/yyyy - mm/yyyy) |
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| Degree Candidate
Yes
No |
Degree(s) Earned |
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| Name of
College/University
2 |
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| Location (City, State/Province, Zip/Postal Code, Country) |
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| Dates Attended |
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| (mm/yyyy - mm/yyyy) |
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| Degree Candidate
Yes
No |
Degree(s) Earned |
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| Name of
College/University 3 |
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| Location (City, State/Province, Zip/Postal Code, Country) |
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| Dates Attended |
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| (mm/yyyy - mm/yyyy) |
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| Degree Candidate
Yes
No |
Degree(s) Earned |
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Please list the names of courses taken and grades earned on a separate document. Please upload this document here.
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| 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 |
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| If you received a GED,
list date |
(mm/dd/yyyy) |
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TEST INFORMATION |
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| Please
self-report your test scores below. The official scores from the appropriate
testing agency may be requested. |
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ACT |
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| Date taken / to be taken |
(mm/dd/yyyy) |
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| English |
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| Math |
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| Reading |
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| Science |
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| Writing |
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SAT |
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| Date taken / to be taken |
(mm/dd/yyyy) |
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| Critical Reading |
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| Math |
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| Writing |
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SAT Subject Test |
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| Date taken / to be taken |
(mm/dd/yyyy) |
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| Subject |
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| Score |
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| Date taken / to be taken |
(mm/dd/yyyy) |
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| Subject |
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| Score |
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| Date taken / to be taken |
(mm/dd/yyyy) |
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| Subject |
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| Score |
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Other Examination |
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| Test Name |
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| Date taken / to be taken |
(mm/dd/yyyy) |
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| Subject |
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| Score |
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Test of English as a
Foreign Language (TOEFL) or Other Exams |
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| Test Name |
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| Date taken / to be taken |
(mm/dd/yyyy) |
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| Score |
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FAMILY INFORMATION |
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| If you are not a minor, it is not necessary to complete this section. |
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| With whom do you make
your permanent home? |
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Both Parents
Parent/Guardian 1
Parent/Guardian 2
Other
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Parent/Guardian 1:
Mother
Father
Legal Guardian |
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| Last Name |
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| First Name |
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| Middle Name |
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| Title (Mr./Mrs./Dr., etc.) |
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| Home
address if different from yours |
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| Address |
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| City/Town |
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| State/Province |
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| Country |
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| Zip/Postal Code |
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| Home Phone |
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| Email |
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| Occupation |
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| Name of employer |
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Parent/Guardian 2:
Mother
Father
Legal Guardian |
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| Last Name |
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| First Name |
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| Middle Name |
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| Title (Mr./Mrs./Dr., etc.) |
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| Home
address if different from yours |
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| Address |
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| City/Town |
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| State/Province |
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| Country |
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| Zip/Postal Code |
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| Home Phone |
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| Email |
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| Occupation |
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| Name of employer |
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ACADEMIC HONORS |
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| 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). |
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FINANCIAL AID |
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| Will scholarships
or financial aid be required in order for you to attend The Akademia? |
| No
Yes |
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| 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. |
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| EXTRACURRICULAR, PERSONAL & VOLUNTEER ACTIVITIES |
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| Please list your principal extracurricular, community and family activities and hobbies in the order of their interest to you. |
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| Activity 1 |
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| Time Invested |
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| Positions held, honors
won or letters earned |
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| Do you plan to participate in college? |
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| Activity 2 |
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| Time Invested |
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| Positions held, honors
won or letters earned |
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| Do you plan to participate in college? |
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| Activity 3 |
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| Time Invested |
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| Positions held, honors
won or letters earned |
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| Do you plan to participate in college? |
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WORK EXPERIENCE |
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| Please list the
principal jobs you have held during the past two years (including summer
employment). |
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| Specific nature of
work 1 |
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| Employer |
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| Approximate Dates |
(mm/yyyy - mm/yyyy) |
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| Approximate Hours Worked Per Week |
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| Specific nature of
work 2 |
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| Employer |
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| Approximate Dates |
(mm/yyyy - mm/yyyy) |
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| Approximate Hours Worked Per Week |
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| Specific nature of
work 3 |
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| Employer |
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| Approximate Dates |
(mm/yyyy - mm/yyyy) |
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| Approximate Hours Worked Per Week |
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PERSONAL ESSAY |
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| 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. |
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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. |
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OTHER INFORMATION |
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| 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
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| Have you ever been convicted of a felony or other serious crime?
Yes
No
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| 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. |
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| Do you enjoy travel? (check one)
Yes
No
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| Would you be
comfortable living abroad for at least one academic year? Yes
No
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| 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
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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. |
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* Required Fields |