New Student Application

Student and Family Information

Student First Name

Student Last Name

Student Preferred Name/Nickname

Student Pronouns Required

She/Her

He/Him

They/Them

Student Date of Birth required

Student Email

Student Phone Number

Student Address

Street Address

City

Region/State/Province

Postal / Zip code

Parent/Guardian #1 Information

Parent/Guardian #1 Name

Parent/Guardian #1 Email

Parent/Guardian #1 Phone Number

Parent/Guardian #1 Address (If it is the same and the student's, write "Same as above.")

Parent/Guardian #2 Information

Parent/Guardian # 2 Name

Parent/Guardian #2 Email

Parent/Guardian #2 Phone Number

Parent/Guardian #2 Address (If it is the same and the student's, write "Same as above.")

Academic Information

Please upload a copy of your child's academic transcript.

Upload File

Upload supported file (Max 15MB)

Financial Information

Please Indicate if you are seeking need-based financial aid.

Yes

Please upload a completed copy of our need based financial aid application.

Upload File

Upload supported file (Max 15MB)

Please Indicate if you are seeking a payment plan.

Yes

Please note, for payment plans, payment of the full tuition and fees must be complete by May 1st of the corresponding academic year.

Signatures

Student Signature

Parent/Guardian Signature

Select a date

Thank you for applying to Education without Walls! We are excited to review your application and will be in touch with a decision within the next week.