TRANSCRIPT RELEASE

Before sending this form (along with one of the addressed envelopes provided) to your child’s present school, please photocopy it for your files.

is applying to Western Reserve Academy. To complete the application, please forward a transcript, including courses now in progress, the most current grades and the last two year’s grades, as well as any available educational testing and/or information regarding this student to:

Admission OfficeWestern Reserve Academy115 College St.Hudson, Ohio 44236

We appreciate your cooperation and thank you in advance for your assistance.

Parent’s signature DateNote to parents: This top page should be given to your child's present school and not returned to Western Reserve Academy.

Western Reserve Academy is committed to maintaining an educational and work climate for all members of the community that is free from all forms of discrimination. In particular, WRA strictly prohibits discrimination based on race, sex (including pregnancy), religion, color, age, national origin, veteran and/or military status, genetic information, disability, sexual orientation, gender identity and/or expression, marital status and parental status.

Western Reserve Academy 115 College St., Hudson, Ohio 44236 Phone: 330.650.9717 admission@wra.net

To The Applicant Please print your name, address and school below Give this form and a stamped, addressed envelope to youread of chool, rincipal or uidance ounselor. They may prefer to submit these forms electronically.

Applicant’s NameFirst Middle Last Current Grade

Applicant’s AddressStreet City State Zip Code Country

Current School Previous School Attended

To The School Official The student named above is an applicant for admission. Please complete this form and include what is listed below. Return the documents in the envelope provided or scan and submit electronically to admission@wra.net.

Please Include:

� Recent teacher reports, if any

� A school profile, if available

� Final or mid-semester grades for fall term (must be included)

� Grades from the previous two years, if available

� Standardized test scores � An official transcript

School serves grades: ________ to ________ Number of students in entire school: ________

In what month does your school begin? ________ end? ________

Please explain your school’s grading system. What is the passing mark? ________ Honors mark? ________

What percent of your students receive which grades? ________

Does your school rank? � Yes � No Is your rank: � Approximate � Exact How many students are in the entire grade? ________

This applicant ranks ________ out of ________ . ________other students share this rank.

Does your school use a block scheduling system? � Yes � No

Are students placed in sections according to ability? � Yes �No If yes, please tell us in which level the applicant is placed for each subject.

OFFICIAL SCHOOL REPORT AND TRANSCRIPTS Western Reserve Academy115 College St., Hudson, Ohio 44236 Phone: 330.650.admission@wra.net

Signature Date School Address

Printed Name Email Address

Title Telephone

Applicant Name

If the applicant’s attendance record is not listed on the transcript, please indicate the number of days he or she has been absent or tardy each year while at your school.

If the applicant is not, or has not, been in good academic standing, please explain.

�Yes � No

�Yes � No

Has the applicant ever been dismissed, suspended, placed on probation or received other serious disciplinary sanction?

Has he or she withdrawn from school voluntarily for an extended period of time for reasons other than those of health?

If the answer to any of these questions is yes, please provide a full explanation on a separate piece of paper.

�Yes � No