Enroll - UStudy Academy

WHICH CAMPUS? *

UStudy Academy@Online, Global: 100% virtual education. Phone: +31 6 1416 2972 UStudy Academy@Watersley, the Netherlands: blended education. Phone: +31 6 3435 4032

WHICH ACADEMIC PATHWAY? *

pathway check

US High School Certificate for Vocational Studies US High School Diploma for Academic Studies (Standard) US High School Diploma for Academic Studies (Advanced) No Pathway (yet), but individual courses

STUDENT INFORMATION:

First name(s), exactly as in passport - please note that this name will appear on the certificate or diploma

Family name as in passport *

Preferred name, if different from first name

Cell Number

Home street and number *

Postal code

City

Country of Residence

Country/Countries of Citizenship

BSN Number

Date of birth (day-month-year)

Hobbies/interests/sports

PARENT/GUARDIAN INFORMATION

First & family name of parent/guardian 1 *

Email parent/guardian 1 *

Cell phone parent/guardian 1 *

First & family name of parent/guardian 2

Cell phone parent/guardian 2

Email parent/guardian 2

EDUCATION INFORMATION AND NEEDS OF MY CHILD *

Currently enrolled at a traditional school, but unhappy with its curriculum and/or support Currently enrolled at a traditional school, but no longer attending (attendance exemption granted) Currently enrolled at a traditional school, but no longer attending (attendance exemption not granted) No longer enrolled at a traditional school (education exemption granted) Completed primary traditional school now ready for a non traditional Secondary Experience My child is gifted My child has learning difficulties My child is on the spectrum Never been enrolled in an online or traditional school

Information about my child's learning experience so far

I am able and willing to support these needs with official documentation that I will send UStudy Academy in a separate email message. For example: diagnosis reports, OPP (development perspective for appropriate education)

I would rate my child's current English language skills (reading, writing, listening and speaking)?

What English proficiency test my child took - if applicable

REASONS FOR ENROLLMENT & FUNDING
Intended start date of studying at UStudy Academy (day-month-year)

Who should be added as an observer on the student's dashboard? An observer is allowed to see progress of the student in the courses and assessment of the work submitted

Parent/Guardian 1 Parent/Guardian 2 Current school of registration (only for UStudy Academy@Online enrollments)

Who will be funding your child's education at UStudy Academy (one or more)? *

I understand that the following services are included in the UStudy Academy program fee:
* Educational materials
* Assessment & support by certified teachers
* Unlimited advice & consult meetings with the Academy's adviser and learning mentor regarding my child and its academic pathway
* Translation of transcripts from Dutch to English
* Transferring in credits from previous schools into the Middle or High school program
* Obtaining a recommendation letter from staff members (teacher, mentor, learning coach, principal)
* 24/7 access to online learning platform
* Tech support
* Personal online mentor
* Personal academic adviser
* Personal college counselor
* Parent support services regarding funding options, leerplicht etc.
* Informational webinars for student & parents
* Certificate, Diploma & Transcripts
* Graduation Ceremony, Cap & Gown

understand that the following services are NOT included in the program fee, but can be purchased for an additional fee if and when needed:
* Dutch as a First Language
* Dutch as a Second Language
* English as a Second Language
* Individual Tutoring (online only)
* SEN Support Program
* Additional credits beyond the required minimum 6 credits for enrollment
* After school club activities e.g. horse back riding
* Shuttle service from and to Sittard train station
* Additional meals at the cafetaria apart from lunch
* Independent Housing on campus (18+)
* Body-Mind Balance personal program
* Costs associated with the Study Abroad High School Program

I have additional information regarding my child I would like to share outside this form with UStudy Academy, before enrollment is made final

Yes No

By submitting this form, I understand and confirm that all information in this form has been completed truthfully.

Application Form

Application Form

Application Form

Online Campus

Watersley Campus