Affix recent photo of

student here.

Admission Application
Applicant Name: ________________________________________________________________
Date of Application __ __ / __ __ / __ __ __ __
MONTH / DAY / YEAR

1. Student
Full Legal Name (as it appears on your passport or birth certificate)
______________________________________________________________________________________________________________________________________
Family Name/Surname Given Name Middle Name

Nickname or English Name ______________________________________________________________________ Gender: Male Female

Home Address—Street/Apt. _______________________________________________________________________________________________
City __________________________________________________________________________________________________________________
State/Province _______________________________ Postal Code ___________________________ Country ___________________________
Postal Address (if different from home) _______________________________________________________________________________________
City __________________________________________________________________________________________________________________
State/Province _______________________________ Postal Code ___________________________ Country ___________________________
Home Phone _________________________________________________ Cell Phone _______________________________________________
Student’s E-mail _________________________________________________________________________________________________________
Date of Birth __ __ / __ __ / __ __ __ __ Place of Birth—City __________________________________________________________________
MONTH / DAY / YEAR
State/Province _______________________________ Country _____________________________
Citizen of (Country) ____________________________________________ Passport Number _________________________________________
Place of Issue ________________________________ Date of Issue __________________________ Date of Expiry _______________________

2. Parents/Legal Guardians
Full Name of Father/Legal Guardian _______________________________________________________________________________________
If same Address—Street/Apt. ___________________________________________________________________________________________________
as above
check City ________________________________________________________________________________________________________________
here. State/Province _____________________________ Postal Code ___________________________ Country ___________________________
Home Phone _________________________________________________ Cell Phone _______________________________________________
E-mail _________________________________________________________________________________________________________________
Employer ______________________________________________________________________________________________________________
Occupation ____________________________________________________________________________________________________________
Business Phone ______________________________________________ Fax ____________________________________________________

Full Name of Mother/Legal Guardian ______________________________________________________________________________________

If same Address—Street/Apt. ___________________________________________________________________________________________________
as above
check City ________________________________________________________________________________________________________________
here.
State/Province _____________________________ Postal Code ___________________________ Country ___________________________
Home Phone _________________________________________________ Cell Phone _______________________________________________
E-mail _________________________________________________________________________________________________________________
Employer ______________________________________________________________________________________________________________
Occupation ____________________________________________________________________________________________________________
Business Phone ______________________________________________ Fax ____________________________________________________
Check here if parents are divorced or separated. Authorizations must be obtained from all parents/legal guardians and others who have legal
rights to make decisions affecting the student.
Parent/legal guardian to contact first in the event of an emergency: ________________________________________________________________
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Student Information (continued)

3. Siblings
Name Gender Age Occupation Living at Home?
______________________________________________________ M F ________ _______________ Yes No
______________________________________________________ M F ________ _______________ Yes No
______________________________________________________ M F ________ _______________ Yes No
______________________________________________________ M F ________ _______________ Yes No
______________________________________________________ M F ________ _______________ Yes No

4. School
You must attach a transcript of courses you have completed during the last three years and the grades you have received to the Educational
Information section of this application. (If your original transcript is not in English, it must be translated to English.)

Name of School You Currently Attend ________________________________________________________________________________________

Check one: Elementary School Middle School Secondary School Check one: Public Private
School’s Religious Affiliation (if any) ___________________________________________________________________________________________

Address—Street _________________________________________________________________________________________________________
City __________________________________________________________________________________________________________________
State/Province _______________________________ Postal Code ___________________________ Country ___________________________
Phone _________________________________________________________________________________________________________________ E-
mail _______________________________________________________ Website _________________________________________________

Your Current Grade Level _______ Year You Will Finish Secondary School _______

What grade do you prefer to enter? (Check one only.) 7 8 9 10 11 12

6 Do you wish to graduate from GRCS? Yes No Undecided (Graduation is not guaranteed to any international student.)

5. Languages
Native Language ________________________________________________________________________________________________________

Proficiency—Please indicate Poor, Fair, Good, Very Good, or Excellent

Non-native Language _______________________ Years Studied _____ Speaking ________ Reading _________ Writing ________

Non-native Language _______________________ Years Studied _____ Speaking ________ Reading _________ Writing ________

Non-native Language _______________________ Years Studied _____ Speaking ________ Reading _________ Writing ________

Non-native Language _______________________ Years Studied _____ Speaking ________ Reading _________ Writing ________

6. Desire to Study Abroad

Briefly give your reasons for wanting to study at Grand Rapids Christian Schools in the US:

international student admission application | personal information | page 2

Student Information (continued)
7. Personal Background
a. Do you have any dietary restrictions? Yes No If yes, please explain (e.g., vegetarian, food allergies, diabetic, etc.)
____________________________________________________________________________________________________________________
b. Are you allergic to any animals? Yes No If yes, which animal(s)? _____________________________________________________
c. Are you allergic to any medications? Yes No If yes, which medication(s)?
____________________________________________________________________________________________________________________
d. Are you taking any medications? Yes No If yes, which medication(s)? Reason for taking the medication(s):
____________________________________________________________________________________________________________________
e. Do you smoke? Yes No If yes, please explain. ___________________________________________________________________
f. Do you drink alcohol? Yes No If yes, please explain. ______________________________________________________________
g. Have you ever been involved with illegal drugs? Yes No If yes, please explain.
____________________________________________________________________________________________________________________
h. Have you ever been arrested or convicted of an offense? Yes No If yes, please explain.
____________________________________________________________________________________________________________________

8. Activities and Interests

Check any activity in which you are interested (check no more than six). Please note: Athletic eligibility or participation is not guaranteed.

American Football Community Work Martial Arts Sailing/Boating Track and Field
Arts and Crafts Computers Movies School Activities Travel
Backpacking Cooking Museums Sewing Visiting Relatives
Baking Drawing/Painting Music Shopping Volleyball
Baseball Family Activities Photography Snow Sports Walking
Basketball Fishing Picnics Soccer Watching TV
Biking Golf Raising Animals Swimming Woodworking
Bowling Hiking Racquetball Table Games Wrestling
Camping History Reading Tennis Writing
Church Activities Ice Hockey Riding Horses Theatre Other: ____________

Please list any other specific interests, hobbies, or activities and any awards or commendations.
_______________________________________________________________________________________________________________________
Do you play in a band or orchestra? Yes No If yes, which instrument(s)? _________________________________________________
Do you participate in any competitive sports? Yes No If yes, which sport(s)? ______________________________________________
What is your religious affiliation? ____________________________________________________________________________________________
Do you attend church? Yes No If yes, how many times do you attend per week? __________________________________________
Are you active in any church groups? Yes No Would you be willing to attend church with your host family? Yes No
Do you have any pets? Yes No If yes, what are they? _________________________________________________________________
Would you be willing to live with a host family that has pets living in the home? Yes No
List the household tasks for which you are responsible at home. ___________________________________________________________________
Would you be willing to contribute to the life of your host family by taking part in household tasks? Yes

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