8/2/2019 OHS Specific Course Application - 2012-13
http://slidepdf.com/reader/full/ohs-specific-course-application-2012-13 1/13
r. 2/22/12 Specific Course Application
SPECIFIC COURSE APPLICATION
2012 - 2013
Applications are currently being accepted on a rolling basis for the 2012-13 academic year as space permits.The earlier an applicant submits an application the higher the priority it will be given in the review,
financial aid, and course enrollment and scheduling processes.
SUBMISSION INSTRUCTIONSApplication materials may be submitted as follows:
By mail to:Director of AdmissionOnline High School at Stanford University220 Panama StreetStanford, CA 94305-4101
By e-mail to:[email protected]
By fax to:(650) 618-1929Attn: Director of Admission
If you have a change of telephone number, email address, or mailing address, please contact the Admission office [email protected].
All application materials to the Online High School will be treated as confidential documents. We cannot return anymaterials; please use discretion in sending original documents.
Please keep a copy of your application and all supporting materials.
IMPORTANT – PLEASE READ:
This application is for students who would like to be considered for admission only to a specificcourse, or a single course in a specific sequence of courses. Students must indicate on theirapplications for which course (or sequence) they are applying, and will be considered foradmission only to this specified course (or sequence). If a students admitted to a specific coursewould like to take additional courses at the Online High School at a later time, he or she willneed to undergo an additional application process.
Students interested in applying for admission to take a single course in an unspecified discipline,or interested in enrolling full-time or part-time should complete the General Application.
For more information regarding enrollment options and the application types, please visit ourAdmission web site.
8/2/2019 OHS Specific Course Application - 2012-13
http://slidepdf.com/reader/full/ohs-specific-course-application-2012-13 2/13
r. 2/22/12 Specific Course Application
Applicant Name: ____________________________
OHS Applicant Number: _____________________
APPLICATION CHECKLIST
The application packet contains the following forms:
1. Application (pp. 1-8)2. Candidate Statement (p. 6)3. Request for Academic Records (p. 7)4. Parent Questionnaire (p. 8)5. Standardized Examination Results (p. 9)6. Teacher Recommendation Form (pp. 10-11)
A complete application consists of the following:To be submitted by the student or parents:! Application (pp. 1-8)! Application fee of $50 paid by check or money order made payable to: Stanford University ! Candidate Statement (p. 6)
! Parent Questionnaire (p. 8) ! Standardized Examination Results (p. 9)
In preparing your application for submission, please:• Use black or blue colored ink (not pencil)• Do not use staples or tape• Do not use presentation folders or binders• For hard copy submissions, print each page on a single side
To be submitted by teachers or schools:! Teacher Recommendation Form sent directly to OHS by at least two teachers who are qualified to comment
on the applicant’s academic work as described on pages 10-11Note: Students applying for a specific course should submit a recommendation from a teacher in a disciplinerelevant to the course for which the student is applying.
! Transcripts or academic records from all schools attended in the last three years as described on page 7
Placement Test and InterviewCandidates may be asked to take a proctored placement exam to determine their eligibility for the course for whichthey are applying. In some cases, candidates may also receive a request for an interview with a member of theAdmission Committee. If either of these is determined necessary, the applicant will be contacted with furtherinstructions.
The Admission Committee reserves the right to request additional information if deemed necessary to evaluate an
applicant’s candidacy.
8/2/2019 OHS Specific Course Application - 2012-13
http://slidepdf.com/reader/full/ohs-specific-course-application-2012-13 3/13
r. 2/22/12 Specific Course Application ! Page 1 of 11
Applicant Name: ____________________________
OHS Applicant Number: _____________________
APPLICATION FEE AND SIGNATURES PAGE
Application Fee! Enclose application fee of $50 paid by check or money order made payable to: Stanford University. ! I am requesting a waiver of the application fee.
Financial Aid! Check this box if you intend to apply for financial aid.! Check this box if you do not intend to apply for financial aid.
Financial aid applications are evaluated independently of admissions applications. We will send financial aidinformation to families who indicate that they are interested in applying for financial aid.
To be read and signed by the applicant:
I, ___________________________________, have truthfully represented myself on this application.Answers to the questions and the work I am submitting are mine alone. I understand that if I amaccepted to the Online High School at Stanford University, any misrepresentation in my applicationmaterials is grounds for expulsion.
Applicant Signature: ________________________________________________ Date: _______________
To be read and signed by the applicant’s parent or legal guardian:
I, ______________________________________, have carefully reviewed my child’s application, includingall work samples, transcripts, score reports, and other attachments. To the best of my knowledge, allinformation included here is correct, and the work that my child is submitting is his or her own. Iunderstand that any misrepresentation in this application is grounds for expulsion from the Online HighSchool at Stanford University.
Parent/Guardian Signature: __________________________________________ Date: ________________
8/2/2019 OHS Specific Course Application - 2012-13
http://slidepdf.com/reader/full/ohs-specific-course-application-2012-13 4/13
r. 2/22/12 Specific Course Application ! Page 2 of 11
Applicant Name: ____________________________
OHS Applicant Number: _____________________
FAMILY CONTACT INFORMATION
Student Information
Name: _____________________________________________________________________ Sex: _________________First Name Middle Name Last or Family Name
Date of Birth: ____________________ Place of birth: ____________________ Citizenship: __________________
Street Address: _____________________________________________________________________________________
City: __________________________ State: _________ Postal Code: ______________ Country: _______________
Home Phone Number: ______________________________ Cell Phone Number: ____________________________
Email: _____________________________________________________________________________________________
Parent/Guardian Information
Name: _____________________________________________________ Relation to Student: ___________________First Name Middle Name Last or Family Name
Street Address: _____________________________________________________________________________________
City: __________________________ State: _________ Postal Code: ______________ Country: _______________
Home Phone: _____________________ Work Phone: ____________________ Cell Phone: ____________________
Email: _____________________________________________________________________________________________
Occupation: _________________________________ Colleges Attended: ____________________________________
Name: _____________________________________________________ Relation to Student: ___________________First Name Middle Name Last or Family Name
Street address: ______________________________________________________________________________________
City: __________________________ State: _________ Postal Code: ______________ Country: _______________
Home Phone: _____________________ Work Phone: ____________________ Cell Phone: ____________________
Email: _____________________________________________________________________________________________
Occupation: _________________________________ Colleges Attended: ____________________________________
Sibling Information (please attach additional sheet if necessary)
Sibling’s Name: _______________________________________________ Date of Birth: _______________________
School Attending: ___________________________________________________________________________________
Sibling’s Name: _______________________________________________ Date of Birth: _______________________
School Attending: ___________________________________________________________________________________
8/2/2019 OHS Specific Course Application - 2012-13
http://slidepdf.com/reader/full/ohs-specific-course-application-2012-13 5/13
r. 2/22/12 Specific Course Application ! Page 3 of 11
Applicant Name: ____________________________
OHS Applicant Number: _____________________
ACADEMIC BACKGROUND
Applicant’s Current School
Name of School: ______________________________________________ Current Grade Level (in 2011-12): _____
Name of Principal or Headmaster: _____________________________________________________________________
School Address: _____________________________________________________________________________________
School Telephone Number: __________________________________ Years of Attendance: ____________________
Please list all schools which you have attended.
Name of School Location Dates Attended Reason for Leaving
If this student has skipped a year, been out of school for a semester or more, or if there is anything else abouthis/her school enrollment we should know, please describe it here or on a separate sheet:
EXTRACURRICULAR ACADEMIC EXPERIENCE
Please list all relevant academic contests and competitions in which you have participated:
Name of Contest or Competition Score or Outcome Date(s) of
Participation
8/2/2019 OHS Specific Course Application - 2012-13
http://slidepdf.com/reader/full/ohs-specific-course-application-2012-13 6/13
r. 2/22/12 Specific Course Application ! Page 4 of 11
Applicant Name: ____________________________
OHS Applicant Number: _____________________
Please list all academic summer programs and/or programs for gifted students you have attended.
Name of Program Subject(s) Studied Dates Attended
Competitive Admission?
(Y/N)
Please share any additional information about your experience with academic summer programs you feel is
relevant to your application.
Please list all online courses or programs you have taken.
Name of Institution of Program Course(s) Taken Dates Attended Grade inCourse(s)
Please share any information regarding your experience with online courses that you feel is relevant to yourapplication.
8/2/2019 OHS Specific Course Application - 2012-13
http://slidepdf.com/reader/full/ohs-specific-course-application-2012-13 7/13
r. 2/22/12 Specific Course Application ! Page 5 of 11
Applicant Name: ____________________________
OHS Applicant Number: _____________________
ACADEMIC PLANNING FOR 2012-13
OHS Course Selection
Indicate which course you are applying to take at the Online High School.
Course Title Course Code
For a list of courses and their descriptions, please see: epgy.stanford.edu/ohs/courses.html
Other Academic Work
Please list all other schools, if any, this student plans to attend during the upcoming school year:
___________________________________________________________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
Other Courses to be taken in 2012-13 School where course will be taken
Please include any additional comments regarding academic planning for this student:
8/2/2019 OHS Specific Course Application - 2012-13
http://slidepdf.com/reader/full/ohs-specific-course-application-2012-13 8/13
r. 2/22/12 Specific Course Application ! Page 6 of 11
Applicant Name: ____________________________
OHS Applicant Number: _____________________
CANDIDATE STATEMENT
Please respond to the following questions in a single written statement in the space below:
1. Why do you want to take the course for which you are applying?2. How does it fit into your broader academic experience?3. Why do you want to take this course at the Online High School?4. How will you adapt to working independently and to working online rather than in a traditional
classroom? How will you manage your time within a less structured schedule? What strategies would youemploy if you hit a roadblock on an assignment? Please use examples from your personal experience toillustrate your answer.
8/2/2019 OHS Specific Course Application - 2012-13
http://slidepdf.com/reader/full/ohs-specific-course-application-2012-13 9/13
r. 2/22/12 Specific Course Application ! Page 7 of 11
Applicant Name: ____________________________
OHS Applicant Number: _____________________
REQUEST FOR ACADEMIC RECORDS
TO THE APPLICANT
We require transcripts or other academic records of the student’s academic performance for the most recent threeyears of schooling. Unofficial copies (photocopies, printouts, faxed copies, etc.) of transcripts and records aregenerally acceptable. Unofficial copies must bear the official insignia of the school or its equivalent. If necessary,the Admission Committee will request an official copy of the documentation from you.
Families of homeschooled children are encouraged to submit a “Plan of Study” document in lieu of transcripts.The “Plan of Study” should outline the academic subjects covered in each year of homeschooling for the last threeyears, including the titles and publishers of any textbooks used, the names of any novels or other books read,descriptions of major projects and assessments, etc. The “Plan of Study” should be limited to two pages for eachyear of homeschooling.
If you intend to submit an official transcript, please fill out the information below and provide a copy of this formto each institution the student has attended in the past three years.
Student Name: _____________________________________________________________________________________
Street Address: _____________________________________________________________________________________
City: _________________________ State: _________ Postal Code: ___________ Country: ___________________
Preferred Phone Number: ________________________ Secondary Phone Number: __________________________
I hereby give permission for the release of my child’s school records as requested by the Online High School atStanford University.
Name of Student: _______________________________________________ Date of Birth: ___________________
Signature of Parent or Guardian: __________________________________________ Date: __________________
TO THE SCHOOL
The above named student has applied for admission to the Online High School at Stanford University. Pleasesubmit an official copy of his or her transcript or record of grades together with any standardized test scores that are available. Please send this information by mail to:
Director of AdmissionOnline High School at Stanford University220 Panama StreetStanford, CA 94305-4101
8/2/2019 OHS Specific Course Application - 2012-13
http://slidepdf.com/reader/full/ohs-specific-course-application-2012-13 10/13
r. 2/22/12 Specific Course Application ! Page 8 of 11
Applicant Name: ____________________________
OHS Applicant Number: _____________________
PARENT QUESTIONNAIRE
Name of parent(s) completing this form: _______________________________________________________________
Relation to Student: ______________________________________________________ Date: ___________________
How would you describe your child’s personality?
What type of school is your child currently enrolled in (public, private, homeschool, etc.)? Why did you make thisdecision?
What are your expectations for your child during his or her time at the OHS?
Please explain why you think OHS would be a good fit for your child.
How much time does your child currently spend on his/her academic subjects outside of the classroom?
How well does your child manage his/her time and work independently?
How does your child respond to challenges?
Describe any areas in which your child may need support.
How do you view your role as a parent in contributing to your child’s success?
It is important that parents and schools have a good working relationship. What kind of feedback do you typicallygive your child’s school? Please give examples.
Parents: To help us get to know your child, please answer the questions below. Feel free to attach additional pages or a typed letter if you need more space.
8/2/2019 OHS Specific Course Application - 2012-13
http://slidepdf.com/reader/full/ohs-specific-course-application-2012-13 11/13
r. 2/22/12 Specific Course Application ! Page 9 of 11
Applicant Name: ____________________________
OHS Applicant Number: _____________________
STANDARDIZED EXAMINATION RESULTS
Please include standardized examination results with your OHS application. Unofficial copies (photocopies,printouts, faxed copies, etc.) of the results are generally acceptable. If necessary, the Admission Committee willrequest an official copy of the documentation from you.
A list of common standardized tests appears below.
Standardized tests often taken by high school students:
ACT – American College Testing Examination: www.actstudent.org
PSAT – College Board Exam: www.collegeboard.com/student/testing/psat/about.html
SAT – College Board Exam: www.collegeboard.com/student/testing/sat/about.html
Standardized tests often taken by middle school or junior high school students:
ISEE – Independent School Entrance Examination: www.erbtest.org/parents/admissions/isee
SCAT – School and College Ability Test: cty.jhu.edu/gifted/dcc/SCAT.html
SSAT – Secondary School Admission Test: www.ssat.org/ssat/info/home.html
In addition to the above tests, applicants may submit results from other nationally-administered examinations to
provide further documentary evidence of ability.
Should you have any questions regarding standardized test scores, please contact the Admission Office.
8/2/2019 OHS Specific Course Application - 2012-13
http://slidepdf.com/reader/full/ohs-specific-course-application-2012-13 12/13
r. 2/22/12 Specific Course Application ! Page 10 of 11
Applicant Name: ____________________________
OHS Applicant Number: _____________________
TEACHER RECOMMENDATION FORM
(Page 1 of 2)
TO THE APPLICANT We request one teacher recommendation from a teacher in the discipline relevant to the course for which you are applying.After completing the information below and signing the waiver statement, give a copy of this form to each teacher from whomyou request a recommendation. Please note that we will not accept any recommendation form without a signed waiverstatement. The Online High School strongly believes that confidential recommendations are essential to obtaining accurateinformation from teachers.
Name: _____________________________________________________________________________________________________________________ Last/Family First/Given Middle
Email Address: ______________________________________________________________________________________________________________
Waiver Statement:
We, the student applying to the Online High School and parents of this student, waive our right to view this recommendation.
Student Signature: _______________________________________________________________________ Date:_____________________________
Parent/Guardian Signature: _______________________________________________________________ Date:_____________________________
TO THE TEACHER
Please fill out the form below and on the second page, and include further comments about the student in the space provided.We appreciate any information that you feel is relevant to determining whether the applicant is suited for the Online HighSchool at Stanford University (OHS). Because the academic program at the OHS is demanding and fast-paced, students need tobe emotionally and socially mature, intellectually very able, and independent in their learning style to succeed. We areinterested in admitting students who can contribute to and lead classroom discussions, work independently and collaborativelyon projects, excite others with their ideas, and enjoy their education. Thus, we are interested in your impressions of thestudent's personal maturity as well as his or her academic ability. The form should not be returned to the applicant’s family.You may wish to keep a copy of the completed form for approximately one month in case the envelope does not reach theAdmission Office.
Fax: 1-650-618-1929
Email: [email protected]
Mailing address: Admission Office, Stanford University Online High School, 220 Panama St., Stanford, CA 94305-4101
Teacher's Name: _____________________________________ Subject Taught: _____________________________Please print or type
Signature: ______________________________________________________________________________ Date:_____________________________
School: _____________________________________________________________________________________________________________________
School Address: _____________________________________________________________________________________________________________Number & Street City/Town State/Province Country ZIP/Postal Code
Teacher Phone: (_____)_________________________________________ Teacher Email: ______________________________________________
How long have you known the student and in what context? Please list the courses you have taught this student, noting foreach the student's year in school and the level of course difficulty (e.g. AP, IB, accelerated, honors, elective).
What are the first words that come to your mind to describe this student?
8/2/2019 OHS Specific Course Application - 2012-13
http://slidepdf.com/reader/full/ohs-specific-course-application-2012-13 13/13
r. 2/22/12 Specific Course Application ! Page 11 of 11
Applicant Name: ____________________________
OHS Applicant Number: _____________________
TEACHER RECOMMENDATION FORM
(Page 2 of 2)
Ratings
Compared to other students in his or her class year, how do you rate this student in terms of the followingcharacteristics? Please mark the correct box for each row with an "X" to denote your rating
No
basis
Below
Average Average
Good
(above
average)
Very good
(well above
average) Excellent
(top 10%)
Outstanding
(top 5%)
One of the
top few I've
encountered
(top 1%)
Academic achievement
Intellectual promise
Quality of writing
Creative, original thought
Productive class discussion
Disciplined work habits
Maturity
Motivation
Leadership
Integrity
Reaction to setbacks
Concern for others
Self-confidence
Initiative, independence
Overall recommendationPlease indicate the level to which you would recommend the applicant (check one).
!
Not recommended !
Recommended !
Highly recommended !
Very highly recommended
Evaluation
Please write whatever you think is important about this student, including a description of academic personalcharacteristics, as demonstrated in the classroom. Because many exceptional students apply to the OHS, wewelcome information that will help us differentiate this student from others. Feel free to attach an additional sheetor another reference you may have prepared on behalf of this student.
We truly appreciate your time and thoughtfulness in commenting on this applicant. Thank you!