Extraordinary by Design
Admission Application
Hannah Holliway
Director of Admission and Financial Aid
717-815-6714 · [email protected]
1071 Regents Glen Boulevard, York, PA 17403 · 717-815-6700 · www.YCDS.org
An affiliate of York College of Pennsylvania
Application Procedures for York Country Day School
Thank you for your consideration of York Country Day School. Please follow the instructions below to
ensure the successful and timely completion of the admission process for your student.
I.
II.
APPLICATION
Please return the following to York Country Day School:
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Completed application with your signature
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Completed Parent Questionnaire
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Completed Student Questionnaire (applicants to grades 6-12)
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Completed Records Request Form
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Copies of candidate’s educational testing (if any)
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Application fee of $35
SCHOOL TOUR
If you have not toured York Country Day, please call us at 717-815-6714 to arrange a personal tour and a
meeting with the Director of Admission.
r
III.
CLASS DAY VISIT
All applicants are required to spend a full or partial school day with student hosts in their current grade
level. Class Day visitors are our guest for lunch.
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IV.
Tour scheduled
Class Day Visit scheduled
TEACHER RECOMMENDATION
Please ask one of your student’s current teacher(s) to complete the grade level appropriate recommendation
form(s) as soon as possible. The recommendation may be mailed or faxed directly to York Country Day
School, Admission Office, 1071 Regents Glen Boulevard, York, PA 17403 or fax 717-815-6769. All
recommendations are confidential and should be forwarded to the Admission Office directly from the
teacher.
Should you have any questions, please call Hannah Holliway, Director of Admission and Financial Aid, at
717-815-6714.
APPLICATION FOR ADMISSION
ACADMEMIC YEAR 2016-2017
Please enclose $35.00 processing fee.
Please specify grade of application:
☐Panda ☐Penguin (3 day) ☐ Penguin (5 day) ☐Pre K ☐K ☐1 ☐2 ☐3 ☐4 ☐5
Lower School
Middle School
☐6
☐7
☐8
Upper School
☐9
☐10 ☐11 ☐12
APPLICANT INFORMATION
Last Name
Home Address Street
(
First Name
City
Middle Name
Nickname
State
Zip
)
Primary Family Phone
Applicant Email Address
Male ☐
Female ☐
Date of Birth (M/D/Y)
Ethnic Background (optional)
ACADEMIC INFORMATION
Present School of Applicant
Principal/Director
Present School Address
City
Prior School(s) Attended
1. 2. 3. State
Principal/Director
Address
Zip
Dates
School District in which the applicant resides:
Has the applicant been evaluated for speech/occupational therapy, gifted program, learning difference, IQ or similar? If so when and by
whom?
If the student has been or is presently suspended or expelled from another school, please complete:
Name of the school that the student was/is suspended/expelled:
Dates of suspension/expulsion:
Reason for suspension/expulsion:
Please provide additional schools and dates of suspension/expulsion as an attachment.
Is there any reason (i.e., tuition debt, textbook debt, etc.) why the student’s current/previous school(s) would not release the student’s
academic or health records? YES ☐ NO ☐
If YES, please specify:
PARENT/GUARDIAN INFORMATION
Parent/Guardian
Parent/Guardian
Name
Name
Home Address
Home Address
Home Address
Home Address
(
(
)
)
Mobile Phone
Mobile Phone
E-mail
E-mail
Occupation/Title
Occupation/Title
Name of Business
Name of Business
Business Telephone
Business Telephone
Colleges/Universities Attended
Colleges/Universities Attended
Degree(s)
Degree(s)
Who will be the primary contact during the admissions process?
With whom does the applicant reside?
Will the family apply for financial aid at sss.nais.org?
ADDITIONAL FAMILY INFORMATION
Siblings of applicant:
Name
Age
Grade
Present School
Relatives who attend or have attended York Country Day School:
Name
Relationship to Applicant
Dates of Attendance
We understand that this application is an expression of intent only and is not binding upon the parent or the school.
We also understand that if the applicant is accepted, enrollment is for the entire academic year. I certify that the
information provided on this application is true and accurate. I understand and agree that the administrator’s and
teacher’s evaluations are confidential and will not be disclosed to me or become part of my child’s permanent file.
Signature of Parent(s)/Guardian(s)
Date
York Country Day School does not discriminate on the basis of race, color, religious creed, national or ethnic origin or gender in its admission policy, recruitment
practices or in the administration of its financial aid programs.
PARENT or GUARDIAN QUESTIONNAIRE
Learning more about you
Parent(s) or Guardian(s) please complete the following questionnaire and submit it with your student’s
application.
Student Name:___________________________________ Applying for grade:______
Parent/Guardian Name(s):
How did you hear about York Country Day School?
What are the qualities about YCDS that interest you? Why do you think these qualities would be a good match for
your family?
What are your expectations of York Country Day School?
See Reverse
What are your expectations for your student in the YCDS setting? Academic, social, extracurricular?
STUDENT QUESTIONNAIRE
Learning more about you
Applicants to Grades 6-12 please complete the following questionnaire.
Name:___________________________________ Applying for grade:______
Please describe something outside of school that you care about and spend time doing. (For example: clubs, music,
sports, school or community groups)
The best book(s) I have ever read is (are)…
Describe a memorable learning experience that you have had.
See Reverse
My biggest challenge is…
Please describe someone who has had a big impact on your life.
I am interested in attending York Country Day School because…
To:
Request for Copies of Student Records
Guidance Office-Student Records
From: Hannah Holliway, Director of Admission
Since review of the academic qualifications of the applicant, _______________________, depends in part
upon any available academic records, we would appreciate your office sending us a copy of the applicant’s
record. The Admission Committee would like to review progress reports and report cards of this and any
previous school years, any standardized test scores, attendance records, disciplinary history, and any other
information which you feel may assist in our review of the applicant. Please send all information to:
York Country Day School
Hannah Holliway, Director of Admission
1071 Regents’ Glen Boulevard
York PA 17403
Fax: 717-815-6769 or email [email protected]
Thank you for your assistance. Please call the Admission Office at 717-815-6714 if you have any questions.
______________________________, Grade,________of_______________________________
(Name of Student)
(Current School)
has applied for admission to York Country Day School to enter grade ________ beginning
_____________,20____. I hereby request progress reports for the past three academic years, all standardized test
scores, disciplinary history, and attendance records for my child be submitted directly to York Country Day School.
Signed:
(Parent/Guardian)
Date :______________