Online Application for Admission

Domestic and International Student Application

STUDENT INFORMATION
Name*
First Last
Date of Birth*
MM
DD
YYYY
Applying for Grade*
Program of Interest
Enrolling Start Date*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Resides With (please check all that apply)
- Father
- Mother
- Stepfather
- Stepmother
- Guardian
- Other
Primary Language*
Ethnicity
Present School*
Present Grade*
PARENT INFORMATION
Parent 1
Name*
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Email*
Occupation
Employer
Relationship Status:*
- Single
- Married
- Separated
- Divorced
- Widow/Widower
- Partnered
Parent 2
Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Email
Occupation
Employer
Relationship status:
- Single
- Married
- Seperated
- Divorced
- Widow/Widower
- Partnered
SCHOOL AND MEDICAL INFORMATION
Has the student ever had a psycho-educational assessment? (If yes, attach report below)*
Does the student have a current IEP or 504? (If yes, attach report below)*
Has the student ever received special services?*
Special services may include: counseling, treatment, tutoring, speech therapy, occupational therapy, etc.
If yes, please explain and attach report below:
Is there any medical or psychological history that may interfere with the student's ability to participate fully in the school's programs?*
If yes, please explain:
Has the student ever been suspended from school or involved with the judicial system?*
If yes, please explain:
ADDITIONAL INFORMATION
Is the student adopted?*
Who should receive correspondence regarding student?*
Who is financially responsible for the student?*
Has any relative attended Leelanau School?
If yes, state name, relationship to student, and years attended?
How Did You Learn About Leelanau:
- Internet Search
- Parent Referral
- Alumni Referral
- Educational Consultant
- Professional
- Radio Ad
- Print Ad
- Local Community
- Other
REQUIRED ATTACHMENTS
If file size is too large to attach. Please email files separately to admissions@leelanau.org.
Photograph
Assessment Report
Transcripts
School Reports (IEP or 504 Plan)
Other Clinical Reports for Special Services
SIGNATURE AUTHORIZATION
We, the undersigned, understand that any information furnished in support of this application shall be complete and confidential, and shall not be disclosed to anyone, including the candidate and his/her family, except that the Director of Admissions may, for official purpose at his/her discretion, disclose any part or all thereof to such person or persons as he/she deems advisable. We further attest that all statements made herein, and on the Student’s and Parental/Guardian Statements are true and complete, and understand that any false statements, or disclosures could result in the dismissal of the applicant, if enrolled.
Signature of Parent or Guardian*
Date*
Date Format: MM slash DD slash YYYY
The Leelanau School adheres to a long standing policy of admitting students of any race, color, creed, religion, orientation, national or ethnic origin to all the rights, privileges, programs, and activities generally accorded or made available to students at the school. The Leelanau School does not discriminate on the basis of race, color, creed, religion, orientation or national or ethnic origin in the administration of our educational policies, admissions policies, scholarship and loan programs, personnel practices or athletic and other school-administered programs

Enjoy our Intro Video

Leelanau School

One Old Homestead Road
Glen Arbor, MI 49636

231-334-5800

The Leelanau School ignites a passion for learning in a boarding school where students thrive by engaging academically and by celebrating everyone’s unique learning styles in a culture of acceptance, leading to successful and meaningful lives in college and beyond.

Online Application for Admission

Domestic and International Student Application

STUDENT INFORMATION

PARENT INFORMATION

Parent 1

Parent 2

SCHOOL AND MEDICAL INFORMATION

ADDITIONAL INFORMATION

REQUIRED ATTACHMENTS

SIGNATURE AUTHORIZATION

Leelanau School