Formulaire de demande d`inscription

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Application for admission / Demande d’inscription
Applying Grade: _______________
Inscription en classe de:
Academic Year applied for: 20____ / 20____
Pour l’année scolaire:
STUDENT’S INFORMATION
Name:
Nom:
_____________________________________________________________________________
Address:
Adresse:
_____________________________________________________________________________
(Last)
(First)
(Middle)
(Number – Street)
_____________________________________________________________________________
(City)
Home Phone#:
(State)
(Zip Code)
_________________________________
Tél. Domicile:
Date of Birth:
Month/Mois:
Place of Birth:
________________________
Date de naissance:
_________
Day/Jour:
Lieu de naissance:
(Country)
Gender:  Male/Masculin
Sexe:
_________
Year/Année:
 Female/Féminin
___________
Countries of Citizenship: ___________________________
Nationalité(s):
_____________________________
Current School:
______________________________________________
Current Grade:
École/Établissement actuellement fréquenté (e):
___________
Niveau de classe actuel:
Language(s) spoken at home: Please check the box of the native/dominant language of each person. Check two or more if
that person speaks all these languages equally well. Specify if necessary.
Langue(s) parlée(s) à la maison: Veuillez cocher la case de la langue maternelle/dominante de chaque personne.
Sélectionnez-en plusieurs si la personne s’exprime indifféremment dans toutes ces langues. Veuillez préciser si besoin.
English
Anglais
French
Français
Other
Autre
Other
Autre
Student / Élève
Mother / Mère
Father / Père
To help us fulfill our obligations as a non-profit organization, please indicate the applicant’s ethnicity (optional):
Pour nous aider à nous acquitter de nos obligations en tant qu’association à but non lucratif, veuillez indiquer l’origine ethnique
du candidat (facultatif):
 Black or African American
 Mixed Ethnicity
 Prefer not to say
 American Indian or Alaska Native
 Asian
 Middle Eastern
For office use only:
Date received: ____ /____ / 20___
Open House attended:
____ /____ / 20___
Entering Grade:
rd
 3 Grade/CE2
 PreK-1/PS
th
 4 Grade/CM1
Fees paid on:
____ /____ / 20___
School Visit: ____ /____ / 20___
 PreK-2/MS
th
 5 Grade/CM2
 Kindergarten/GS
th
 Caucasian/White
 Hispanic or Latino
 Native Hawaiian or Other Pacific Islander
 6 Grade/6
ème
 Cash
 Paypal
 Check#: _____
Student Evaluation:
____ /____ / 20___
 1st Grade/CP
 2nd Grade/CE1
th
 7 Grade/5
ème
 8th Grade/4ème
Student’s Name /Nom de l’élève: _________________________________________________________
STUDENT’S INFORMATION (CONT’D)
School(s) previously attended / École(s) fréquentée(s) auparavant:
-
School Name: ____________________________
Nom de l’école:
Grade: ____
Classe:
Phone#:
_______________________
No Téléphone:
-
School Name: ____________________________
Nom de l’école:
Grade: ____
Classe:
Phone#:
_______________________
No Téléphone:
-
School Name: ____________________________
Nom de l’école:
Grade: ____
Classe:
Phone#:
_______________________
No Téléphone:
Siblings / Frères et soeurs:
-
First Name:
Prénom:
______________________
Age: ____
Âge:
School attended: _______________________________
École fréquentée:
-
First Name:
Prénom:
______________________
Age: ____
Âge:
School attended: _______________________________
École fréquentée:
-
First Name:
Prénom:
______________________
Age: ____
Âge:
School attended: _______________________________
École fréquentée:
GENERAL INFORMATION
Parental marital status / Situation de famille des parents:
Parents not married/Union libre
Other (please specify)/Autre (veuillez préciser):
 Married/Mariés
 Separated/Séparés
 Divorced/Divorced
_____________________________________________________
Who is financially responsible for payment of tuition and/or other school expenses?
Qui est responsable financièrement des frais de scolarité de l’enfant et/ou autres dépenses concernant l’école?
 Parents/Parents
 Mother/Mère
 Father/Père
 Other (specify)/Autre (veuillez préciser)
______________
Employer's participation towards school tuition / Participation de l'employeur aux frais de scolarité
 No/Non
 Yes/Oui
If yes, indicate the Company’s name/Si oui, veuillez indiquer le nom de l’entreprise: ________________________________
French Government Scholarships / Bourses scolaires du gouvernement français
I would like to apply for tuition scholarship from the French Government
Je souhaite faire une demande de dossier de bourse auprès du gouvernement français
 Yes/Oui
 No/Non
 Yes/Oui
 No/Non
Financial Aid program / Programme d’aide financière
I would like to apply for tuition assistance through the FASP Financial Aid Program
Je souhaite faire une demande d’aide financière via le programme de l’école
How did you hear about the French American School of Princeton? (check all that apply)
Comment avez-vous entendu parler de FASP ? (cochez toutes les options possibles)
Open House/Journée Portes ouvertes
FASP Parent (Name)/Parent de l’école (Nom) _________________________
 Internet Search/Recherche sur internet
Magazine or Newspaper Ads/Publicité dans les magazines ou les journaux
 Word of Mouth/Réputation
www.princetonkids.com
 Consulat Général de France à New York
 Other (please specify)/Autre (veuillez préciser):
 www.princetonol.com
 Facebook Page
________________________
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Student’s Name /Nom de l’élève: _________________________________________________________
MOTHER’S INFORMATION
Name:
_____________________________________ Citizenship(s): _____________________________
Nom:
(Last)
Home Address:
______________________________________________________________________________
Adresse domicile:
(Number – Street)
(First)
Nationalité(s):
(if different from applicant - si différent de celui de l’enfant)
______________________________________________________________________________
(City)
Phone#:
Nos Téléphone:
(State)
Work/Bureau: _________________________
(Zip Code)
(Country)
Cellular/Portable: _________________________
Email addresses: Home/Domicile: _________________________________________________________________
Adresses email:
Work/Bureau:
_________________________________________________________________
Company Name:______________________________________ Job Title:
Nom de l’entreprise:
_____________________________
Fonction:
Address:
______________________________________________________________________________
Adresse:
(Number – Street)
______________________________________________________________________________
(City)
(State)
(Zip Code)
(Country)
FATHER’S INFORMATION
Name:
_____________________________________ Citizenship(s): _____________________________
Nom:
(Last)
Home Address:
Adresse domicile:
______________________________________________________________________________
(Number – Street)
(First)
Nationalité(s):
(if different from applicant - si différent de celui de l’enfant)
______________________________________________________________________________
(City)
Phone#:
Nos Téléphone:
(State)
Work/Bureau: _________________________
(Zip Code)
(Country)
Cellular/Portable: _________________________
Email addresses: Home/Domicile: _________________________________________________________________
Adresses email:
Work/Bureau:
_________________________________________________________________
Company Name:______________________________________ Job Title:
Nom de l’entreprise:
_____________________________
Fonction:
Address:
______________________________________________________________________________
Adresse:
(Number – Street)
______________________________________________________________________________
(City)
(State)
(Zip Code)
(Country)
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Student’s Name /Nom de l’élève: _________________________________________________________
What are your motivations for providing your child with a bilingual education?
Quelles sont les raisons qui vous motivent à offrir à votre enfant une éducation bilingue?
___________________________________________________________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
Please tell us more about your child’s personality:
Veuillez décrire la personnalité de votre enfant en quelques mots:
___________________________________________________________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
Any additional comments:
Commentaires supplémentaires:
___________________________________________________________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
SUBMIT APPLICATION PACKAGE:
Please save the completed document and then return it electronically to the Admissions Office at
[email protected]
ENVOYER LE DOSSIER D'INSCRIPTION:
Veuillez sauvegarder le document complété, puis envoyez-le en pièce jointe via email au bureau des admissions à
[email protected]
The French American School of Princeton does not discriminate on the basis of race, creed, color, national
origin, religion, gender, sexual preference or disability in its programs, administrative policies and admissions.
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