8/3/2019 2011-12_Senior School Application
1/17
Dear Parent/Guardian,
Thank you for your interest in having your child considered for admission to Woodstock School.
The Woodstock academic year begins in early August. There is a winter break from mid Decemberthrough early February. The school year ends in mid June.
The admission process is as follows:
Complete the application forms and send them to the Woodstock School Admissions Officeeither by scanned email to [email protected] or by courier or registered post to theaddress set out on the next page. A non-refundable application fee of US$80 or `4,000/- mustbe sent with the application.
Once all application materials have been received, the application will be reviewed bymembers of the Admissions Committee. You will then receive an email either to let youknow:
o that the school will not be considering the application any further and that the studentwill not be offered a place at Woodstock. This will bring the admissions process to anend; OR
o to set a date for the admission test and interview. Most test dates are scheduledbetween February and April. The admission test and interview may be waived forstudents residing outside of South East Asia.
Where applicable, the admission test and interview as well as a tour of the school andresidences will take place.
The completed application material for those still being considered will be reviewed anddiscussed by the Admissions Committee.
A final decision from the Admissions Committee will be communicated to the family viaemail.
Please note that an application will only be considered once all the materials set out in the
checklist on the next page have been submitted. The application will not be reviewed or
considered until all the items have been received.
Applications for the start of the 2011-2012 school year need to be received by the 10 th of March2011. Applications received after the 10th of March, or applicants having an admission test andinterview after 15th of April will be considered for admission only if there are vacancies and may beplaced on a waiting list.
We look forward to learning more about your child.
Sincerely,
Kirsten Bradby
Director of AdmissionsPhone (91) 135 661 [email protected]
8/3/2019 2011-12_Senior School Application
2/17
Checklist for Senior School applicants:
Completed application form (5 pages)
2 recent passport size photographs
Copy of birth certificate or passport of applicant
Copy of birth certificate or passport of father and mother of applicant
Completed Student Medical History form
Completed Writing sample(s)
Signed Statement of Understanding
Official transcript or copies of report cards clearly showing grades or marksreceived during the last 2-3 years, as well as any standardized test scores that areavailable (do not send originals-they may not be returned)
Parent Feedback form (optional)
Application fee of US$ 80 (cheque) or `4,000/- (Demand Draft) madepayable to Woodstock School
Completed Confidential Reference Forms - please give one to either the currentPrincipal or the Guidance Counselor; one to the current English teacher; and oneto the current Mathematics teacher.
Each reference form needs to be completed and sent either directly by emailfrom the referee to [email protected] or in a sealed envelope to the
Admissions Office. Please note that unsealed references coming through theparent are not acceptable.
Please complete and send the above listed materials either by scanned email [email protected], or by courier or registered post to the following address:
Director of AdmissionsWoodstock School
Mussoorie, Uttarakhand 248179
India
8/3/2019 2011-12_Senior School Application
3/17
APPLICATION FOR ADMISSION
WOODSTOCK SCHOOL
MUSSOORIE UTTARAKHAND 248179 INDIA
STUDENT INFORMATION
Student name Gender
(last name) (first name) (middle name)
Birth date Place(day/month/year) (city) (country)
Nationality Passport (please specify country)
Permanent address
Home phone
Present class/grade Class/grade into which admission desired
If applying for admission to class/grade nine or above, in which country is the student expected to attend university?
Sibling Information (if applicable)
Name of Sibling Male/Female Date of birth Current School
_______________________ __________ _____________ _______________________________________
_______________________ __________ _____________ _______________________________________
_______________________ __________ _____________ _______________________________________
_______________________ __________ _____________ _______________________________________
_______________________ __________ _____________ _______________________________________
Woodstock Alumni
If any members of your close family (parents, siblings, other children, etc.) have studied at Woodstock School, pleaselist their names and the years they attended.
Application Form page
1/5
8/3/2019 2011-12_Senior School Application
4/17
FAMILY INFORMATION
Father/Guardians information Mothers information
Name: Name:
Address: Address: (if different from Father)
Street address Street address
City City
State pin/zip code State pin/zip code
Country Country
Email: Email:
Home phone: Home phone:
Mobile phone: Mobile phone:
Business phone: Business phone:
Date of birth: Date of birth:(day/month/year ) (day/month/year)
Place of birth: Place of birth:(city) (country ) (city) (country)
Citizenship: Citizenship:
Religion: Religion:
Educational background:_______________________ Educational background:_______________________
Country in which educated: Country in which educated:
Occupation: Occupation:
Employer (if any) Employer (if any)
Employers address: Employers address:
Student lives with: Both parents Father Mother Guardian (specify) _______________________
The parents are: Married Divorced Separated Widowed
Person responsible for payment of fees:
Financial assistance from Woodstock School may be available in certain circumstances. Please refer to the websitewww.woodstock.ac.in for further details. A grant application form may be requested by emailing the Admissions Officeat [email protected]
Application Form page 2/5
8/3/2019 2011-12_Senior School Application
5/17
EDUCATIONAL HISTORY OF STUDENT
Name of present school Language of instruction
Address of present school
_________________________________________________________Telephone
Name of principal at present school Principals email
Date of entrance to present school Date of proposed leaving
Please list PREVIOUS schools attended, if any:
School Name City and Country Dates ofAttendance
GradeCompleted
Language ofInstruction
1.
2.
3.
Has the student been suspended/expelled from any school? Yes NoIf yes, please explain the circumstances
LEARNING PROFILE
Has the student ever been tested (or referred for testing) for any of the following:
Learning difficulties Yes No Behavioral difficulties Yes No
Emotional difficulties Yes No Physical difficulties Yes No
If yes, please describe ___________________________________________________________________________
Has the student ever received any of the following services? Please check all that apply.
English as a Second Language Gifted/talented/honors program Psychological counseling
Personal counseling Physical/occupational therapy Remedial educational program
Speech/language therapy Other: (Please list)
If you checked any of the above, please explain ______________________________________________________
Do you anticipate your child needing additional support in any subject areas? Yes No
If yes, which subject(s)?
Has the child ever been evaluated by a psychiatrist, psychologist, speech/language therapist, educational diagnostician or
other specialist? Yes No
If yes, please specify which type of specialist and send a copy of the report _________________________________
Is the student now, or has he/she ever been on any long-term medication?
If yes, please explain
Has the student ever skipped a grade/class in school? Yes No If yes, which grade/class?
Please explain the circumstances
Has the student ever repeated a grade/class in school? Yes No If yes, which grade/class?
Please explain the circumstancesHas the student ever missed twenty (20) days or more of school in a school year? Yes No
If yes, please explain the circumstances
Application Form page 3/5
8/3/2019 2011-12_Senior School Application
6/17
PARENT EVALUATION: We understand that it may be difficult for a parent to objectively evaluatehis/her own child. However, we believe that your comments will be of value to us, particularly as comparedwith responses from others not so close to the student.
Please indicate your appraisal of your childs attitude toward school work, on a scale of 1-5(1 = low, 5 = high)
1 2 3 4 5 Comments
Organizational skills
Enjoyment of school
Motivation to study on his/herown
Study habits
Please indicate your appraisal of your child with respect to the following characteristics. Please circle
the most appropriate response for each category.
Conduct: frequent misconduct occasional misconduct usually good conduct good conduct
Consideration of others: rarely considerate usually considerate considerate
Fulfills responsibilities: rarely sometimes usually always
Initiative: never initiates rarely initiates occasionally initiates often initiates
Integrity: questionable usually trustworthy trustworthy
Leadership potential: a follower occasionally leads seeks opportunities to lead a natural leader
Maturity in terms of age/ grade: very immature somewhat immature mature very mature
Personality: withdrawn shy warm sociable
Relationships with peers: relates poorly has occasional problems has healthy relationships
Self-confidence: needs much reassurance needs some support has a positive self-image
Language Spoken at Home: (Please list the language most commonly used)
Between mother and student: Between father and student:Between siblings: Between parents:
Please answer the following questions. Feel free to attach an additional page, if necessary.
Why do you wish your child to study at Woodstock?
What special attributes will your child bring to Woodstock if he/she is offered admission?
Application Form page 4/5
8/3/2019 2011-12_Senior School Application
7/17
AGREEMENT: (please read carefully and sign below)
I understand that the School allows no claim of priority due to the date of application or length of time of correspondenceand makes no promise of admission until the applicant is formally offered a place in writing.
I understand that all students are admitted as boarders. Exceptions may be made for a small number of students underspecial circumstances.
I understand that learning about Christianity is an integral part of the Schools curricular programme and agree to mychilds participation. I also understand that all Woodstock students attend School assemblies where Christian worship ispart of the regular programme.
I agree to comply with the regulations of the School including those relating to timely payment of fees, the charging ofinterest on unpaid bills and the assessment of fees for less than 90 days notice of a students withdrawal or for the latearrival or early departure of a student.
I confirm that all the above information concerning my child is true to the best of my knowledge. I authorize WoodstockSchool to verify or clarify the above information with anyone concerned. I understand that if any information contained inthe application is found to be false or misleading, the School may take appropriate action. This may include rejection ofthe application, withdrawal of any offer of admission, or immediate removal of the student from the school.
Parents Name (print)
Parents Signature Date
Application Form page 5/5
8/3/2019 2011-12_Senior School Application
8/17
STUDENT MEDICAL HISTORY FORM
Name Gender ________________Birth Date(Day/month/year)
FAMILY HEALTH HISTORY: Circle to indicate any occurrence of the following:
Alcoholism Cancer High blood pressure Rheumatic feverAllergies Diabetes Kidney disease TuberculosisArthritis Epilepsy Mental illnessAsthma Heart disease
Has there been a death of a close family member in the past year? Date
Relation to student Cause
PERSONAL HEALTH HISTORY: Tick the Yes column to indicate if the student currently has or has ever had any ofthe following:
Yes Date Yes Date YesDate
Childhood Diseases Chest/Respiratory Skin Conditions
Chicken Pox Asthma Eczema
Diphtheria Chronic bronchitis Impetigo
Measles Chronic cough Frequent boils
Mumps Chest pain Scabies
Polio Heart/Blood Disorder Neurological ConditionsWhooping Cough Rheumatic heart disease Convulsion/Epilepsy
Other Diseases Other Heart problems Dizziness/Fainting
Dengue High Blood Pressure Frequent headaches
Hepatitis (Jaundice) Hemophilia Neuritis
Malaria Other Conditions
Mononucleosis
Excessive bleeding after
Injury or tooth extraction InsomniaRheumatic Fever GI/GU Conditions Sleep Walking
Tuberculosis Appendicitis Alcoholism/Drinking
Typhoid Abdominal pain Depression
Ear/Nose/Throat Bladder infection Drug Habit
Frequent colds Diarrhea/dysentery Hysteria
Frequent earaches Gall Bladder Mental illness
Draining ears Frequent indigestion Psychiatric treatment
Frequent nose bleeds Hemorrhoids Smoking tobacco habit
Frequent sore throats Hernia Chronic Pain
Tonsillitis Kidney infection ADHD
Any Deafness Autism
Tooth/Gum problems
Hay Fever allergies
Female applicants only:
(a) Does the student have any problems during menstruation (if applicable)? YES NO
If yes, please give details: __________________________________________________________________________
________________________________________________________________________________________________
(b) Does the student have any gynecological problems? YES NO
If yes, please give details: __________________________________________________________________________
________________________________________________________________________________________________
Medical History Form Page 1/2
8/3/2019 2011-12_Senior School Application
9/17
ALLERGIES:
DRUGS:YES NO - If yes, please state which drug and what treatment has been or is being given.
FOOD:YES NO - If yes, please state which food and what treatment has been or is being given.Peanut AllergyYES NO
OTHER:YES NO -If yes, please state the allergy and which drug and treatment has been or is being given.
KNOWN MEDICAL CONDITIONS:
Does your child suffer from any medical conditions for which he/she requires medication to control symptoms? E.g.,
asthma, skin conditions, etc.
If yes, please give details:
Condition:
Date Diagnosed:
Medication being taken:
Please record any other illness, injury, or operations your child has experienced.
Illness:
Date:
Injury:Date:
Operations:
Date:
OTHER
Does the student:
Wear glasses or contact lenses? YES NO
Wear a hearing aid? YES NO
Have a problem with bed wetting? YES NO
Have on-going dental treatment now? YES NO
If yes, please tick one of the following:
Treatment will be completed while home on vacation
Treatment will be continued by orthodontist or dentist recommended by Woodstock.
I confirm that I have completed this form to the best of my knowledge and ability and that any known medical conditions
of the applicant have been disclosed.
Name (print)
Signature Date
Medical History Form page 2/2
8/3/2019 2011-12_Senior School Application
10/17
SENIOR SCHOOL APPLICANT WRITING SAMPLE
PART A(to be completed byALL Senior School applicants)
Please write a brief essay, approximately 250-300 words, neatly in your own handwriting, whichincludes all the following topics. Please use paper, plain or ruled, of this approximate size.
Note: If called for test, this writing sample will be cross-checked against the test writing sample. This must be
your own work.
1. Your interests and/or hobbies2. Your extracurricular activities/involvements outside of school.3. What you think are your areas of strength. What areas you would like to improve.4. Why you want to study at Woodstock.5. What you think you will enjoy most about boarding. What you think will be the greatest
challenge.
6. What contribution you hope to make to life at Woodstock.7. What you hope to gain by studying at Woodstock.8. What you hope to be doing in 20 years time.
Please confirm that the essay is entirely your own work by including the following statement at theend of your essay and signing your name:
On my honor, I pledge that I have not received
improper assistance in completing this task.
Senior School Writing Sample Page
8/3/2019 2011-12_Senior School Application
11/17
SENIOR SCHOOL WRITING SAMPLE
PART B(to be completed by applicants forGrades 9-12only)
Please submit a brief (250-300 word), handwritten essay onone of the following topics. Please usepaper (plain or ruled) of about this size and indicate at the top of the page which essay you haveselected.
Note: If called for test, this writing sample will be cross-checked against the test writing sample. This must be
your own work.
A) Imagine that you could have lunch with any person, living or dead. Describe the conversationthat the two of you might have.B) Write about a fictional character from a book you have read that resembles someone you
know. Describe the similarities and differences.
C) You have just finished writing your 300 page autobiography. Please submit (write out) onlypage 217.
Please confirm that the essay is entirely your own work by including the following statement at theend of your essay and signing your name:
On my honor, I pledge that I have not received
improper assistance in completing this task.
Senior School Writing Sample Page 2/2
8/3/2019 2011-12_Senior School Application
12/17
STATEMENT OF UNDERSTANDING
Please read the following statement carefully, tick the boxes, and sign below.
Having read the literature carefully, I am aware that Woodstock School is an International Schoolwith a student body drawn from more than twenty countries, representing a wide variety of culturaland national backgrounds.
I understand that Woodstock School is rooted in a Christian heritage which seeks to encouragethe highest standards of citizenship, personal integrity, and community relationships. I understandthat the standards of the school are drawn in accordance with the schools Christian philosophy, andalso in recognition of the fact that the school is situated in India.
I understand that failure to live up to the standards of the school may lead to disciplinary action,including expulsion. These standards include respecting the culture and traditions of India and thepeople that live both within and outside of the school boundaries.
I recognize the need for honesty and integrity and will strive to live in peace and harmony withall other persons in the school community. I understand that students of Woodstock School arerequired to adhere to the Woodstock Honor Code: I will not lie, cheat or steal. I will encourageevery member of the Woodstock Community to faithfully uphold the Honor Code.
I understand that bullying, gambling, drug abuse, smoking, alcohol consumption, and sexualimmorality are forbidden and will be treated as serious offenses.
Having read the above statement carefully, I will give wholehearted support to these rules and goals
if I am admitted as a student to Woodstock School.
Signature of Applicant: Date:
Student name (print):
I understand and accept the above statement and will wholeheartedly support the rules and goals if
my child is admitted as a student to Woodstock School.
Signature of Parent: Date:
Parent name (print):
Statement of Understanding page 1/1
8/3/2019 2011-12_Senior School Application
13/17
CONFIDENTIAL REFERENCE FOR SENIOR SCHOOL APPLICANT
to be completed by currentPRINCIPAL orGUIDANCE COUNSELOR
is an applicant for admission to Woodstock School.(Please insert applicants name)
We value your assessment of this student as an integral component of the students application for admission. Yourforthright answers will help us to determine if this student is likely to be successful at Woodstock School.
Please complete this confidential recommendation form and return it to the Admissions Office either by email to
[email protected] or in a sealed envelope, at the following address:Director of Admissions
Woodstock SchoolMussoorie, Uttarakhand 248179
India
LEARNING PROFILE: Please answer the following questions to the best of your ability.
1) Has the student worked up to his/her potential? Please explain. ___________________________________
2) Has the student ever been tested (or referred for testing) for:Learning difficulties Yes No Behavioral difficulties Yes No
Emotional difficulties Yes No Physical difficulties Yes No
If yes, please describe
______________________________________________________________________________________
3) Has the student ever received any of the following services? Please check all that apply.
English as a Second Language Gifted/talented/honors program Psychological counseling
Personal counseling Physical/occupational therapy Remedial educational program
Speech/language therapy Other: (Please list)
If you checked any of the above, please explain.
4) Do you anticipate this student needing additional support in any subject areas? Yes NoIf yes, which subject(s)?
5) Has the student ever been evaluated by a psychiatrist, psychologist, speech/language therapist, educationaldiagnostician or other specialist? Yes No
If yes, which specialist(s)?
6) Is the student now, or has he/she ever been on any long-term medication?If yes, please explain
7) Has the student ever skipped a grade/class in school? Yes No If yes, which grade/class?Please explain the circumstances
8) Has the student ever repeated a grade/class in school? Yes No If yes, which grade/class?Please explain the circumstances
9) Has the student ever missed twenty (20) or more school days in a school year? Yes NoIf yes, please explain the circumstances ______________________________________________________
Senior School Principal or Guidance Counselor Reference Page
8/3/2019 2011-12_Senior School Application
14/17
APPLICANT INFORMATION: Please comment on this student with respect to the following.
Circle the most appropriate answer for each category.
Ability to express ideas
orally:
limited fair good exceptional
Ability to follow directions: needs much explanation occasionally needs help usually understands followsdirections well
Concentration: lacks concentration easily distracted Occasionally distracted alwaysconcentrates
Conduct: frequent misconduct occasional misconduct usually good conduct good conduct
Consideration of others: rarely considerate usually considerate considerate
Fulfills responsibilities: rarely sometimes usually always
Initiative: never initiates rarely initiates occasionally initiates often initiates
Integrity: questionable usually trustworthy trustworthy
Leadership potential: a follower occasionally leads seeks opportunity to lead natural leader
Maturity in terms of age/
grade:
very immature somewhat immature mature very mature
Organizational skills: disorganized somewhat organized usually organized highly organizedPersonality: withdrawn shy warm sociable
Relationship with peers: relates poorly has occasional problems has healthy relationships
Self-confidence: needs much reassurance needs some support has a positive self-image overlyconfident
Sense of humor: rarely laughs or smiles fair good delightful
Study skills: requires closesupervision
occasionally needs help works independently
RECOMMENDATION: Please circle the most appropriate response for each category
For Academic Promise: not recommended without enthusiasm fairly strongly strongly enthusiasticallyFor Character and Personal
Promise: not recommended without enthusiasm fairly strongly strongly enthusiastically
Overall Recommendation: not recommended without enthusiasm fairly strongly strongly enthusiastically
Please summarize your reasons for your recommendation:
Is there any additional information regarding the student or the students family which you think might or should
influence our decision?
Signature Position
Name (printed) Date
Email address Telephone
May we contact you directly if we have further questions or concerns? Yes No, I would prefer you do not
Senior School Principal or Guidance Counselor Reference Page 2/2
8/3/2019 2011-12_Senior School Application
15/17
CONFIDENTIAL REFERENCE FOR SENIOR SCHOOL APPLICANT
to be completed by the current ENGLISH TEACHER
is an applicant for admission to Woodstock School.(Please insert applicants name)
We value your assessment of this student as an integral component of the students application for admission. Yourforthright answers will help us to determine if this student is likely to be successful at Woodstock School.
Please complete this confidential recommendation form and return it to the Admissions Office either by email to
[email protected] or in a sealed envelope, at the following address:
Director of AdmissionsWoodstock School
Mussoorie, Uttarakhand 248179India
ENGLISH INFORMATION: Please circle the most appropriate response in each category:
Ability to Analyze Text: Weak Below Average Average Above Average Outstanding
Comprehension of Abstract Ideas: Weak Below Average Average Above Average Outstanding
Creative Expression: Weak Below Average Average Above Average Outstanding
Grasp of Grammatical Concepts: Weak Below Average Average Above Average Outstanding
Oral Expression: Weak Below Average Average Above Average Outstanding
Reading Retention: Weak Below Average Average Above Average Outstanding
Reading Speed and Ability: Weak Below Average Average Above Average Outstanding
Vocabulary Mastery: Weak Below Average Average Above Average Outstanding
Written Expression: Weak Below Average Average Above Average Outstanding
Overall Rating: Weak Below Average Average Above Average Outstanding
Please indicate your appraisal of the students attitude toward school work, on a scale of 1 (low) to 5 (high)
1 2 3 4 5 Comments
Effort put forth toward studying:
Enjoyment of school:
Motivation to study on his/her own:
Study habits:
Do you predict that this student will be capable of working at an advanced level?
Additional comments (time management skills, consistency of performance, study habits, participation in class, etc). Feel
free to attach an additional sheet, if necessary.
Signature of Teacher Name of Teacher (printed)
Date Email address: Telephone
May we contact you directly if we have further questions or concerns?
Yes
No, I would prefer you do notSenior School English Teacher Reference Page 1/1
8/3/2019 2011-12_Senior School Application
16/17
CONFIDENTIAL REFERENCE FOR SENIOR SCHOOL APPLICANT
to be completed by the current MATHEMATICS TEACHER
is an applicant for admission to Woodstock School.(Please insert applicants name)
We value your assessment of this student as an integral component of the students application for admission. Yourforthright answers will help us to determine if this student is likely to be successful at Woodstock School.
Please complete this confidential recommendation form and return it to the Admissions Office either by email to
[email protected] or in a sealed envelope, at the following address:
Director of AdmissionsWoodstock School
Mussoorie, Uttarakhand 248179India
MATH INFORMATION: Please circle the most appropriate response in each category:
Application of Concepts: Weak Below Average Average Above Average Outstanding
Basic Skills: Weak Below Average Average Above Average Outstanding
Computation: Weak Below Average Average Above Average Outstanding
Problem Solving: Weak Below Average Average Above Average Outstanding
Overall Rating: Weak Below Average Average Above Average Outstanding
Please indicate your appraisal of the students attitude toward school work, on a scale of 1 (low) to 5 (high)
1 2 3 4 5 Comments
Effort put forth toward studying
Enjoyment of school
Motivation to study on his/her own
Study habits
Do you predict that this student will be capable of working at an advanced level? ________________________________
Additional comments (time management skills, consistency of performance, study habits, participation in class, etc). Feel
free to attach an additional sheet, if necessary.
Name of Teacher (printed) Signature of Teacher
Date Email address Telephone
May we contact you directly if we have further questions or concerns? Yes No, I would prefer you do not
Senior School Mathematics Reference 1/1
8/3/2019 2011-12_Senior School Application
17/17
PARENT FEEDBACK FORM (optional)(Help us do a better job)
How did you first learn about Woodstock School? Please select one.
Woodstock website Friend Family member Former student Educational journal (please list) Woodstock staff member
Other website (please list) Education Fair
Other (please list)
What sources of information regarding Woodstock School did you consult to help you make your decision? Please checkall that apply.
Woodstock website Family member Friend Woodstock staff member
Woodstock Alumni Educational Journal (please list)
Other website (please list) School prospectus and brochures
Other (please list)Was it easy to find the information you needed on the Woodstock Website?
Yes No If not, what was difficult?
What information could be added to the Woodstock School website to make it more useful?
Why have you chosen to apply to Woodstock School for your child? Please select 5 of the following answers and rank
them in order of importance with 1 being the most important.
Are there any parts of Woodstocks life and program that worry you? Please check any that apply, and explain further
in the space below:
Comments:
Please list up to 3 other schools that you are considering for your child:
____ Boarding experience ___ Diverse student and staff body ___ Quality of teachers___ Childs wishes ___ Extracurricular/leadership opportunities ___ Recommendation of Alumni___ Christian heritage of school ___ Facilities ___ Reputation of the school___ College preparation ___ Increase childs independence ___ Scholarship program
___ Cost of education ___ Location of school ___ Subject choices___ Develop childs character ___ Music program ___ Values of the school___ Other (please state) __________________________
Boarding experience Facilities Subject choices
Christian characteristics of school Location of school Values of the school
Cost of education Quality of teachers Outdoor education
Discipline system at school Reputation of the school Other (please list)
Diverse student and staff Student life at school