Admissions Application I am interested in applying beginning * Required Fall Winter I am interested in applying beginning in How did you hear about Noorthoek Academy?Current schedule- more details on semester registration forms. Arts and Sciences 100: Wednesday 11 a.m-12:30 p.m. Wednesday 1:00-2:45 p.m. Thursday ZOOM 10:00 a.m.-11:15 a.m. Thursday 1:00 p.m.-2:45 p.m. Friday 1:00-2:40 p.m. Saturday 10 a.m. - 11:45 a.m. Creative Writing 100: Thursday 11 a.m.-12:30 a.m. Today's Date - must be mm/dd/yyyy format * Required MM slash DD slash YYYY Student Name * Required First Last Address * Required Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home Phone * RequiredCell PhoneDate of Birth * Required Gender Email Who do you live with? * RequiredSelectIndependentFamilyGroup homeOtherParent/Relative Name * Required First Last Parent/Relative Email * Required Parent/Relative Phone * RequiredContact person name * Required First Last Contact person Email * Required Contact person phone number * RequiredDo you have a caseworker or other support professional? Yes No Caseworker Name * Required Agency Phone * RequiredPhone extension Email * Required Please list names, email, and phone numbers for any other caseworkers or support professionals. * RequiredParents/ Caseworkers- Interested in volunteering during classes? Yes No Important Information about Disabilities & other medical info. * RequiredHigh School Attended * Required Year of High School Graduation/Completion * Required NameIf you completed high school in the last 5 years, please provide a person from your school who we can contact. School contact person phone numberList any activities in which you participate (Sports, clubs, music, etc.)Job/Workplace Volunteer Why do you want to attend Noorthoek Academy? * RequiredStudents are responsible for providing their own transportation to and from classes. Do you need help with this? Yes No Tuition is $200 for one semester. If you choose and are accepted into multiple classes, you receive a discount for each subsequent class. Tuition is NON-REFUNDABLE. If you are in financial need, partial scholarships are available.Signed * RequiredI agree that if I am accepted by Noorthoek Academy, I will abide by the rules, expectations of the staff, and board of directors. I understand that any inappropriate behavior (aggressiveness, inappropriate sexual conduct, etc) could result in the termination of my attending Noorthoek Academy. Date - must be mm/dd/yyyy format * Required MM slash DD slash YYYY For more information or to discuss financial need, please call the Education Director at 616-634-8352.