Online Admissions Application Student InformationName* First Last Preferred Gender*Birth Date* Date Format: MM slash DD slash YYYY Applying for academic year*Please select one.2020-20212021-20222022-20232023-2024Entering Grade*9101112Applicant’s email address Applicant’s cell phoneParent 1 or guardian’s informationParent 1 or guardian’s name* First Last Parent 1 or guardian’s relationship to applicantParent 1 or guardian’s mailing address* Street Address Address Line 2 City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Parent 1 or guardian’s residential address (if different from mailing) Street Address Address Line 2 City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code OccupationBusiness name and addressCell phoneHome phoneWork phoneEmail* Parent 2 or guardian’s informationParent 2 or guardian’s name First Last Parent 2 or guardian’s relationship to applicantParent 2 or guardian’s mailing address (if different from Parent 1) Street Address Address Line 2 City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code OccupationBusiness name and addressCell phoneHome phoneWork phoneEmail Family informationIf parents live separately, child lives withParent 1Parent 2BothSchool correspondence should be addressed toParent 1Parent 2BothNames and birth dates of other children in familyApplicant informationSchool(s) applicant has attendedSchoolCity and StateDates attended Current or last grade attendedHas the applicant received extracurricular tutoring or remedial help?Has the applicant received psychological counseling? Please explain.Has the applicant ever been suspended from or expelled from a school or school program?Does the applicant have any physical, physiological, or psychological conditions of which we should be aware?If yes, is the applicant currently taking any medication(s) for this condition?Will the applicant enroll in*German language studySpanish language studyDoes applicant play a musical instrument? If one or more, please listPlease upload a writing sample (3MB limit)Please upload a writing sample—an essay or other written work—that the applicant completed as an assignment from his or her present or most recent school. Word, PDF or Text ONLY.Accepted file types: doc, docx, pdf, rtf, txt.Is the applicant’s family planning to apply for financial aid?YesNoHow did you hear about our school?$80 non-refundable application fee*The Berkshire Waldorf High School admits students of any race, color, national and ethnic origin to all the rights, privileges, programs, and activities generally accorded or made available to students at the school. It does not discriminate on the basis of race, color, national and ethnic origin in administration of its educational policies, admissions policies, scholarship and loan programs, and athletic and other school-administered programs. Amount: $80.00 By checking this box, you agree to our Privacy Policy*View the Privacy Policy here. Opens in a new tab. Agree Select Payment Method*If paying by check, please make payable to Berkshire Waldorf High School and write "Application Fee" in the memo field. Check should be mailed to: Berkshire Waldorf High School P.O. Box 905 Great Barrington, MA 01230Will Mail Check / Alternative PaymentPayPal (Use Your Credit Card)Stripe (Credit Card)Credit Card American ExpressDiscoverMasterCardVisa Card Number Expiration Date Month010203040506070809101112 Year20202021202220232024202520262027202820292030203120322033203420352036203720382039 Security Code Cardholder Name