Since 1792

Washington Academy

Agent Manual

2015-2016

Washington Academy66 Cutler Rd. East Machias, ME 04630

I would like to take this opportunity to thank you all for all the work that you do recruiting for WA. Here at Washington Academy, we are happy to partner with you and together help our students make choices that will positively impact their future.

Washington Academy has welcomed international students for many years. The Admissions Department is always seeking to improve the application process that we believe will enhance our admissions assessment and more accurately place students so they can be successful at WA.

English proficiency scores prior to student enrollment are no longer required at Washington Academy.We still ACCEPT all English Proficiency tests if they are included in the student application, but they are notrequired. We will test all students upon arrival for placement in the appropriate English classes. WA is introducing a new SHORT- TERM STUDY ABROAD Program. Students can choose the time of year, the number of months, one semester, a summer, or a full year for their Study Experience in Maine, USA. As we are already accepting students for 2016, we encourage students to start the admissions process early so there is enough time to get ready for the spring or fall, and especially for those who plan on enrolling in the summer program or requesting consideration for financial assistance. Once again, we thank you for your cooperation and if you have any further questions regarding this matter, please do not hesitate to contact anyone in the Admissions Department. We are happy to assist you. You can download our Agent Manual on our website under the Admissions portal at www.washingtonacademy.org. We look forward to a continued working relationship with you.

Sincerely,

The Admissions Department at Washington Academy

Robin Moloff-Gautier, DirectorBrittany Sawyer, Admissions CounselorTheresa Farnsworth, Admissions Office Manager

Since 1792Celebrating Over 220 Years of Excellence in Education

Sailing on nearby Indian Lake

Washington Academy is set in a town of less than 2,000 and is 3/4 day students, with a 1:14 student/teacher ratio, so it has a real family feel. Strategies like pairing new students with local student mentors help them quickly feel at home.

WA makes the most of its coastal environment, including the school’s four acres of waterfront property. Students stay active mountain biking, hiking, and boating—learning how to responsibly enjoy and care for the earth.

WA has 440 students (50% boy/girl ratio), with 100 of them

add a great deal to the school while gaining the unique New England education they’re looking for.

at WA—students of all academic abilities and varied interests.

some of whom are nationally recognized, make it all possible.

In WA’s coastal ecology program, students are making a real

lifechanging program, students learn about everything from creating seaweed biodiesel to restoring the Atlantic Salmon.

Parents and consultants appreciate WA’s small town setting, along with the fact that so many adults live on campus. In East Machias, the school is still the center of the communi-ty—a place where parents, students, and educators truly look out for one another.

Not all students are looking for a traditional academic pro-

health occupations, engines, and culinary arts. Even coastal studies, though certainly academic, is very hands on.

For city kids, being on a lobster boat or going downhill skiing

Academy students experience the best of New England and Atlantic Canada.

gracious competitors—and fellow students, faculty, and com-munity members are their greatest fans.

Washington Academy. One recent visiting parent said, “Everyone I’ve met at WA is so positive and considerate. It’s not just politeness—it’s real.”

Here are 10 reasons we hear most often why ed consultants enthusiastically recommend Washington Academy:

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SUMMER at WA2015

Option1-Academic Session 1: July13-July 31

Coastal Ecology/Outdoor LeadershipCollege WritingTOEFL Prep American History

College WritingTOEFL Prep BASIC ESLMarine Biology/ESL ScienceAmerican Literature

FEE INCLUDES:

Includes: all tuition, room, board, materials, excursions, field trips, activities after school, on weekends; use of chromebook. In addition, all students will be picked up at the Bangor Airport upon arrival and delivered back to Bangor Airport in time for departure back home. Dormitories staffed full time. Shuttle bus to town.

Use of WA Fitness Center, gymnasium, tennis courts, 5K hiking trail, UMM pool and fitness center.

Health insurance is extra and can be purchased from WA for $150 per month. (Current cost to WA).

For Basic English Language Learners

********Students enrolled at Washington Academy for full time study for 2015-16 receive

$500 scholarship for Summer Intensive ESL Institute********

Option 2-Academic Session 2: August 3-August 21

Option3-Intensive ESL Institute: August 3-28

BASIC ESLAmerican CultureESL Science

$4,000US

$4,000US

$4,500US

Visit www.washingtonacademy.org for more information.Email: admissions@washingtonacademy.org for

application and details.

“I came to WA for the Summer Term and I had a great expereince and made a lot of friends. After classes, we went everywhere...shopping, the amuesment park, the firness center, the pool. We played golf and went to the beach often. The teachers were all so nice and patient. They helped me fit in to the U.S. lifestyle quickly.” -William, China, student.

“I am surprised by the many cultures here at WA. It is so interesting for me to learn about other cultures, especially the American culture. Everyday I learn something new. Summer at WA was so much fun, and not routine at all! I came back after my WA summer to be a full time student here. -Anastasia, Russia, student.

Early College Opportunities at Washington Academy Since 1792, Washington Academy has been providing a high quality comprehensive curriculum that ranges from hands-on career-oriented programming to fundamental high school classes to honors program to more than 12 advanced placement classes. Junior and senior students can also take college courses at the local university, and WA now offers nine university courses on its own campus through Husson University. Students can choose from 10 different courses and receive college credit for all courses passed. In addition to the credits earned, the Early College program at WA allows students to gain priceless college classroom experience before heading off to university. The academic program at WA serves every student and prides itself on students achieving success. Many of the classroom teachers are alumni of the Academy and have been with the school for many years. Their experience as students and now as teachers make the Washington Academy’s most valuable resource for our students. College courses taught by Washington Academy faculty right on campus for dual credit: Anatomy & Physiology General Biology English 1 English 2 Western Civilizations Algebra Probability & Statistics Sociology Psychology Plus…take college course at the local University as a junior or senior and receive college credit BEFORE graduating from high school. Credits may transfer to the university of your choice. Advanced Placement Classes at Washington Academy

Including....ChemistryPhysicsBiology US History Language and Composition Literature Calculus AB/BC European History Latin Spanish Studio Art

As the global economy continues to expand, the demand for international business education is higher than ever and expected to increase.

In response, WA has introduced its Interna-tional Business Program, which combines the study and comparison of political and social structures in various countries with fundamen-tal micro- and macro-economics, and diplo-

macy. Marketing, business applications using QuickBooks, entrepreneurship, Chinese Lan-guage and Chinese Culture fill out this innova-tive program which students will find relevant in today’s rapidly changing world.

Studying international business gives our students an understanding of how business

activities are influenced by the political, eco-nomic, and cultural diversity of today’s multi-national business environment. Students will study finance, business law, accounting, man-agement and operations, tourism, and market-ing as well as a foreign language in this dy-namic program.

The integration of technology provides stu-dents with the skills demanded by employers. In addition, students will have opportunities to enhance their skills in leadership, project man-agement, cultural awareness and teamwork throughout this program.

International Business at Washington Academy

The Marine and Engine Technology (MET) program combines the skills and knowledge of Marine Boat-Building and Navigation with those of Engine Technology and Electrical systems. It is designed to develop practical and necessary skills that men and women will be able to use no matter what career path they choose.

Juniors and seniors will receive experience preparing them for careers in such fields as marine mechanics, small engine repair, marine electrical systems, boat-building and more.

Some of the topics that will be offered are: units in tool & machine use, safety, woodworking, boat and kayak building, maintenance, repair and restoration. Outboard motor maintenance and computer aided drawing (CAD) will be included. The MET engine program is a hands-on approach of diagnostics, repair, servicing and electrical principles of diesel engines and instructed with the latest tools and special equipment.

MARINE AND ENGINE TECHNOLOGY

The Outdoor Leadership and Management course is a two year program designed to develop leadership, management, and decision making skills that men and women will be able to use no matter what career path they choose.

Juniors and seniors will receive experience preparing them for jobs such as guiding hunters, fishermen, bird watchers, and kayakers, as well as learn outdoor recreation, forestry, small business, human relations and land management.

Some of the topics that will be offered are: ecology, business, canoeing/kayaking, map and compass, hunter safety, first responder qualification, search and rescue, GPS/GIS mapping, fly fishing, archery, wilderness camping, hiking, and snowshoeing.

One goal of the course will be to have students that choose to, take their Maine Guide test after they have reached the age of eighteen.

OUTDOOR LEADERSHIP & MANAGEMENT COURSE

Engineering Technologiesand Mathematics

Honors Discrete MathematicsGrades: 11-12This course is intended as an elective for those students pursuing a 4-year college program following high school graduation, or as a prerequisite for students intending to take Advanced Placement BC Calculus. The course begins with a review of trigonometry, followed by polar functions, analytic geometry, vectors and vector spaces, including 3-dimensional analysis, sequences and series and an exploration into the algebra of linear systems, including determinants.

Engineering Technology Grades: 11-12This project-oriented course will serve as an introduction to Engineering and Design. Students will be actively engaged in both improvement of everyday objects and technologies and the development of new prototypes through the systematic application of the “Engineering and Design Process.” A goal for this course is to develop each student’s constructive instinct and understanding of physics principles into the habits and operations of an engineer. Emphasis will be placed on student’s documenting and formal reporting of their design project results. Students will be required to keep a course notebook and journal, work as a member of a team, and fulfill homework assignments. Several off campus enrichment trips are planned as well as collaboration with local engineering projects. Topics of study will include cost analysis, design loops, efficiency and energy transfer, form and function analysis, green energy, material science and structural design principals, thermodynamics and more.

*****NEW CLASSES FOR 2012-2013*****

Martha Jordan, Math Department Chairm.jordan@washingtonacademy.org

James Ausprey, Science Department Chairj.ausprey@washingtonacademy.org

RoboticsGrades: 11-12 The course is designed so that students can explore the interac-tion between science and technology. Students will work in small groups to research, design, program, and construct robotic devices that perform a certain task, or tasks. Students will discover applications for robotic devices in industry, exploration, search and rescue, among others, as they design robots to perform tasks that simulate these applications. They will learn about some of the history of robotic devices, current uses, and be encouraged to think of ways to improve their designs, as well as create designs with new applications. Throughout the process of design and construction, students will need to work through the engineering cycle while applying the scientific method and knowledge from other subjects, for example, mathematics, physics, as well as art. Robotics will expose the student to applications in mechanical engineering, electrical engineering, and computer programming. It is hoped that some will be inspired to pursue engineering beyond high school.

A Day in the Life of a WA Residential StudentMonday-Friday

7:20 AM Breakfast served in Cafeteria Mandatory 7:50 AM Bell for Classes to Begin 2:10 PM Four Block School Day Ends 2:10-2:40 PM Prep Time for Afternoon Blocks 2:45-4:15 PM Afternoon Blocks Mandatory M-TH (4 days) 4:15-5:30 PM Advisor Time/Free Time 5:30-6:15 PM Dinner Mandatory

Sunday-Thursday

6:15-8:15 PM Free Time/ Quiet Hours in Dorm 8:15 PM Dorm Curfew-Attendance in Dorm-Prep for Study Hours 8:30-10:00 PM Quiet Hours in Dorm Rooms 10:00 PM Prep for Lights Out/Room Curfew/Room Check 10:30 PM Lights Out-Computers Off/Room Check

Friday

6:15-11:00 PM Free Time 11:00 PM Dorm Curfew-Quiet Hours/Prep for Lights Out 11:45 PM Room Curfew/Room Check 12 Midnight Lights Out-Computers Off/Room Check

Saturday

11:00 AM-12:00 PM Brunch 5:30-6:15 PM Dinner 6:15-11:00 PM Free Time 11:00 PM Dorm Curfew-Quiet Hours/Prep for Lights Out 11:45 PM Room Curfew/Room Check 12 Midnight Lights Out-Computers Off/Room Check

Sunday

11:00 AM-12:00 PM Brunch 5:30-6:15 PM Dinner 6:15-8:15 PM Free Time 8:30-10:00 PM Quiet Hours in Dorm Rooms 10:00 PM Prep for Lights Out/Room Curfew/Room Check 10:30 PM Lights Out-Computers Off/Room Check

Tim Reynolds Judson McBrine Valerie Renshaw

Associate Head of School Head of School Guidance Director

Mary Ellen Day Robin Moloff- Gautier Assistant Head of School Director of Advancement

Consultants/Representatives Agreement

School Year 2015 - 2016 This agreement is entered into between (AGENT) and the following educational institution:

Washington Academy

P.O. Box 190

66 Cutler Road

East Machias, ME 04630

Phone (207) 255-8301, Ext. 207

Fax (207) 255-8303

URL: www.washingtonacademy.org

Wire Transfer Information:

Machias Savings Bank

P.O. Box 318

4 Center Street

Machias, ME 04654

Routing Number: 211274531

Account: 8012713570 Account Name: Washington Academy - General

Fund

This contract shall commence on the date of this Agreement and continue through the 2015-2016 school year.

Either party may terminate this agreement upon not less than sixty days prior written notice to the other party.

Obligation of the School:

Washington Academy (WA) will provide admissions material for distribution and will forward

updated materials when needed.

After a candidate is accepted, Washington Academy will send a letter of acceptance to (AGENT).

When (AGENT) confirms the student will attend and the enrollment deposit of $3,000 USD has

been paid, Washington Academy will send the I-20 and enrollment agreement contract to (AGENT).

Obligation of the Consultant:

The consultant/representative agrees to provide the school’s promotional material and application

forms to prospective students. The consultant will have the responsibility of identifying, recruiting,

obtaining documentation and facilitating the process of applications for qualified students who have

the ability to benefit from the education offered at Washington Academy.

(AGENT) will be responsible for signing the school’s enrollment contract and guaranteeing payment

of the agreed funds by the deadlines indicated on the enrollment contract for each student. Late

payments are subject to interest charges as indicated on the enrollment contract, and commission may

be forfeited or reduced if payments are not received by WA by agreed deadlines.

Payment to the Consultant:

Washington Academy will pay (AGENT) 15% of tuition, room and board, excluding any additional fees, for

each registered and paid in full student recruited by (AGENT) for each year of attendance at Washington

Academy. Agencies whose students enrolled as first year freshmen, and remain at WA for the full four years

and graduate from WA, including attending the graduation ceremonies, will be entitled to a bonus

commission; payable after student completes graduation from WA.

Commission for each student will be paid upon invoice by agency within the current school year, and

only after all balances for every student are paid in full.

Independent Contractor: For all purposes, the Consultant shall be an independent contractor and not an

officer or employee of Washington Academy.

The fee structure for the 2015-2016 school year at Washington Academy is as follows:

s

In Witness Whereof, the parties have duly executed this Agreement as of the written date.

By:

Robin Moloff-Gautier, Director of Advancement

Admissions, Development & Residential Life Date:

Washington Academy

By: _____________________________ Date:

(AGENT)

Please retain a copy of this agreement and return a signed copy

to Washington Academy, in care of Robin Moloff-Gautier. Thank you!

________________________________________________________________________________________

66 Cutler Road, P.O. Box 190, East Machias, Maine 04630 USA Tel. (207)255.8301

admissions@washingtonacademy.org Fax (207)255.8303

7 Day Resident in Home Stay or Dormitory …………………………..…. $38,000

(Tuition/Room/Board)

Student Life …………………………………………………………………$ 3,000

English as a Second Language Programs Program placement dependent on test scores, grades and writing sample.

University Prep Program…………………………………………….$2,500

Integrated Transitional Language Program………………………..$4,500

Individualized Immersion Program………………………………....$5,500

Emergency Reserve Fund/Room Deposit (refundable if not used) $ 1,250

Tuition reimbursement Insurance (optional)………………………………...$ 1,000

Health Insurance……………………………………………………………...$1,250

Application Fee……………………………………………………………...$ 50

Please note that all students are required to have health insurance coverage upon arrival to Washington

Academy. Washington Academy provides insurance at an approximate cost of $1,250

for 10 months. Health Insurance rates fluctuate from year to year.

MASTERING ENGLISH AS A SECOND LANGUAGE

ADMISSIONS OFFICE 66 Cutler Road, PO Box 190, EAST MACHIAS, ME 04630PHONE (207) 255-8301, EXT. 210 FAX (207) 255-8303

www.washingtonacademy.orgemail: admissions@washingtonacademy.org

Tuition and Feesfor the 2015-2016 School Year

7-Day Boarding Dorm or Host Home . . . . . . . . . . . . . . $ 38,000 Tuition/Room & Board

Activity & Technology Fees. . . . . . . . . . . . . . . . . . . . . . . . $ 3,000

University Prep Program . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,500

Integrated Transitional Language Program . . . . . . . . $ 4,500

Individualized Immersion Program. . . . . . . . . . . . . . . . $ 5,500

Tuition Reimbursement Insurance (Optional) . . . . . . $ 1,000

Emergency Reserve Fund/Room Deposit . . . . . . . . . . $ 1,250

Enrollment and Payment of Tuition

A student will be considered enrolled at Washington Academy upon the receipt of a signed contract and a $3,000 non-refund-able enrollment deposit. The contract includes the terms andconditions of enrollment and intended payment plan.

Washington Academy does not discriminate on the basis of sex, race, age, sexual preference, ethnicity, disability or religion in its admission process. All international and domestic boarding stu-dents at Washington Academy are eligible for consideration of financial assistance. Financial aid dollars are limited and are given on a first-come first-serve basis, based on need and past academic performance. Judson L. McBrine Robin Moloff-Gautier Head of School Admissions Director

Washington Academy Tuition Refund Plan Policy

Virtually all independent schools require full payment of tuition and other fees for the entire academic year; however Washington Academy understands that the tuition payment is substantial and does allow 60% payment by July 1st and 40% by November1st. Independent school expenses are incurred on an annual basis and schools cannot refund charges paid or forgive unpaid obligations in the event a student leaves during the academic year. Washington Academy requires full payment of tuition and fees for the entire academic year, regardless of whether a student withdraws during the year. However, to alleviate in part the �nancial di�culties caused when a student withdraws before the academic year has been completed, Washington Academy has a Tuition Refund Plan available. Parents must sign up and pay for the Tuition Refund Plan at the time of enrollment. Parents who elect not to participate in the Tuition Refund Plan will not receive any refund upon early withdrawal or dismissal of their student. For purposes of the Tuition Refund Plan, the BASIC FEE is de�ned as the annual charge made for tuition, room, and board less the required non-refundable deposit. Plan Cost The cost of the Tuition Refund Plan is $1,000.00 payable upon enrollment. Plan Benefits Subject to the exceptions set forth below, in the event the student withdraws prior to the end of the year, the Tuition Refund Plan will refund up to 50% of unused portion of the Basic Fee if the student elects to withdraw. This Plan does not apply to and no refund is available for any fee charged by Washington Academy other than the Basic Fee as de�ned ab ove. All ou tstanding charges owed to Washington Academy will be deducted from any refund due under the Tuition Refund Plan before payment is made. In addition, where a withdrawal falls within the exceptions set forth below, no refund will be made even though the parent has elected to participate in the Tuition Refund Plan.

Exceptions No refund is allowed for any absence or early withdrawal or dismissal due to:

1. The use or possession of alcohol or any drug, narcotic or an agent which is similarly classed or has similar e�ects unless given by and while under the care and attendance of a legally quali�ed medical practitioner

2. Actions that would endanger other students, faculty, or sta�, 3. Intentionally self-in�icted injuries, 4. Pregnancy, childbirth, or miscarriage 5. Boycotting of classes by the student 6. Insurrection, rebellion, riot, civil commotion, war or act of war, or any governmental order directed to

the student, 7. Destruction of any school facility due to any cause whatsoever, 8. Inability of the school to oper ate and provide formal academic instruction, including closure for any

reason, or 9. Being inducted or drafted into the Armed Forces includ ing altern ative duty as a conscientious objector.

In addition, no refund is available for reasons such as: a withdrawal or absence from class attendance for the balance of the academic year due to early completion of academic requirements, transferring to another school, early graduation, a student’s temporary absence, expulsion or suspension, a change from resident to day status,or returning home for reasons other than medical. The Head of School reserves the right to determine when and if a refund is owed.

Additional Residential Fees

2015-2016 School YearThe following fees are not required, but may be incurred for the services listed:

Billing Charge $15

Dorm Monitor (Suspensions)/Work Service $15/hour Dorm Repairs Actual cost Key Replacement- Standard $75

Lock Replacement $150

Medical/ Counseling Actual Costs not covered by insurance

Postage Actual Cost

Room Cleaning in Excess of Standard $50 minimum

Transport to Bangor Airport/Bus $55 per person by bus After Hours Transport to Bangor Airport/Bus $75 per person by bus(Departing WA before 5:30 AM or arriving at WA after 11:30 PM) Transport to Bangor by Private Car $175 (two people share cost)(Departing WA after 5:30 AM or arriving at WA before 11:30 PM)

After Hours Transport to Bangor by Private Car $225 (two people share cost)(Departing WA before 5:30 AM or arriving at WA after 11:30 PM)

Other Transport To Be Determined(surcharge will apply if dep. WA before 5:30 am State Mileage Rate* x mileage

or arrive WA after 11:30 pm) *Currently 44 cents per mile. Subject to change.

Home Stay for Holiday Break $50/day(upon availability)

NOTES: 1. Dorms are closed during Christmas and April Holiday breaks-all students must leave campus.

2. Deadlines for tuition payments are June 1 (Plan A) and September 1 (Plan B) for full year enrollment.

3. Wire payments to: Machias Savings Bank, 4 Center Street, Machias, Maine USA 04654; Account Name: General Fund; Account

Number: 8012713570; Routing Swift Number: 211274531. Please reference the student’s name under Beneficiary.

Celebrating 220 years of excellence in education!

▪

▪

Payment Method: Check Wire Transfer

If you choose to pay by check, please remit your amount due with a copy of this form to the

following address:

Admissions Office

Washington Academy

P.O. Box 190 66 Cutler Road

East Machias, ME 04630

If you choose to pay by wire transfer and need a swift code, please direct your payment to the

following bank name and address:

Intermediary Bank:

Wells Fargo Bank

420 Montgomery Street, 7th Floor

San Francisco, California USA 94104

SWIFT CODE: WFBIUS6WFFX

Beneficiary Bank:

Machias Savings Bank

4 Center Street

Machias Maine USA 04654

Routing/ABA#: 211274531

Beneficiary Name:

Washington Academy - General Fund

66 Cutler Road, P.O. Box 190

East Machias, ME 04630

Account #: 8012713570

For further credit to: (Insert student’s name)*

Account Name:

Washington Academy – General Fund

*Please reference the student’s name on the wire transfer

so the payment will be credited to the proper student’s account.

Since 1792

SAMPLE

Enrollment Agreement 2015-2016

Washington Academy (WA) agrees to conditionally enroll Jane DOE in grade 10, as of August 28, 2015. Final placement will be determined by final transcripts of current year and placement testing upon arrival. TERMS AND PROVISIONS OF ENROLLMENT The undersigned agrees to pay tuition and deposits in accordance with the Tuition Payment Plan selected below and all charges incurred by the student while enrolled at Washington Academy, in accordance with the procedures and due dates prescribed by Washington Academy. WA reserves the right to place students in a different grade, if deemed appropriate for success. ENROLLMENT DEPOSIT An enrollment deposit in the amount of $3,000 is due and payable within 10 days of the date of this enrollment agreement. The enrollment deposits will be applied to tuition. Checks should be made payable to Washington Academy, wire transfers should be made to Machias Savings Bank, 4 Center Street, Machias, ME 04654 Account Name: General Fund, Account Number: 8012713570, Routing/ Swift Number: 211274531. This deposit is non-refundable, except in cases of visa denial, and then only according to the Visa Denial Refund Policy. TUITION PAYMENT PLAN In the event that the undersigned does not make all payments in accordance with the Plan chosen above, Washington Academy will have the right to choose to charge a late fee of the greater of $500 or 2.5% of the outstanding balance. Washington Academy shall have the right to charge this fee for each month that the account remains delinquent. At any time that the account remains delinquent, WA will have the right to dismiss the student for non-payment. If no plan is selected, Plan A will be in effect.

RESIDENCY Students contracting to live in residence on campus do so for the entire school year. Changes in residence to off-campus home stay mid-year will incur additional charges. DISMISSALS/WITHDRAWALS The Academy reserves the right at any time to suspend, dismiss, or require the withdrawal of a student in accordance with rules and regulations described in the Student/Parent and Residential Life Handbooks, or when, after due notice, payments on account of such student are in arrears. If a student withdraws, is suspended, or is dismissed, for any reason during the school year, the payer will be held responsible for full payment of tuition and fees. When a withdrawal or dismissal falls within the exceptions as outlined in the Tuition Refund Plan Policy, no refund will be given. The Academy reserves the right to withhold official transcripts of, or refuse to graduate, any student whose financial account is not in good standing. Washington Academy does not discriminate on the basis of race, creed, color, or sex in the administration of its educational admissions, or financial aid policies. All students are provided all the rights, privileges, and social, academic, and athletic programs that are made available to students generally in the school. Emergency Funds are refundable and refunds must be requested within 60 days of the close of the current schoolyear, otherwise funds will be directed to the school's Annual Fund.

Enrollment Agreement 2015-2016

Washington Academy (WA) agrees to conditionally enroll Jane DOE in grade 10, as of August 28, 2015. Final placement will be determined by final transcripts of current year and placement testing upon arrival.

Academic Year 2013-2014 Tuition & Fees Tuition/Room/Board $38,000.00 Activity Fee $ 3,000.00 Student Health Insurance Policy* $ 1,250.00 Individualized Immersion ESL Program $ 5,500.00 Summer Program $ 0.00 Tuition Refund Plan-opt. $ 1,000.00

Subtotal $48,750.00 Financial Assistance ($ 0.00)

Subtotal ($ 0.00) Refundable Emergency Reserve Fund $ 1,000.00 Room Deposit $ 250.00

Subtotal $ 1,250.00 Total Due $50,000.00

*This amount must be paid unless the Enrollment Agreement is accompanied by proof of health insurance satisfactory to Washington Academy from a U.S. based insurance company. If satisfactory proof of insurance is received within 30 days of the receipt of the Enrollment

Agreement, the amount charged by Washington Academy for health insurance will be credited against the student’s Emergency Fund. TUITION PAYMENT PLAN (Please check one)

( ) Plan A – Full Tuition and fees payment by July 1, 2015

( ) No, I would not like to enroll in the Tuition Refund Plan. (If not selected, you will be enrolled in the Tuition Refund Plan.)

( ) Plan B – 60% Tuition Paid by July 1, 2015; remaining 40% paid by September 1, 2015 *****If no plan is selected, Plan A will be in effect.*****

I/we hereby agree to enroll the above candidate and to pay the entire annual tuition and other expenses in accordance with the terms and conditions set forth above. I/we have read these provisions and agree to be bound by their terms. ______________________________ ________________ ________________________________ ________________________ Name of First Paying Party Signature Date Name of Second Paying Party Signature Date _________________________________________________ ___________________________________________________________ Address Address _________________________________________________ ___________________________________________________________ Relationship Relationship _________________________________________________ ___________________________________________________________ Telephone Fax Telephone Fax

Jane DOE is accepted into grade at Washington Academy by the Admissions Committee on May 1, 2015.

_______________________________________________________________ _________________________________

Head of School Signature Date

Please return signed original to: Admissions, Washington Academy, East Machias, Maine 04630

Next Steps:Before you arrive

What to do before you arrive:

You must have paid the U.S. SEVIS Fee of $200.00 and have a printed receipt that proves payment

before your visa interview. Find out how to pay your SEVIS fee at www.FMJFee.com.

Apply for your visa as soon as possible! There may be considerable wait time for both the visa interview and visa processing. Wait time information for specific embassies and consulates is available at: http://travel.state.gov/visa/temp/wait/wait_4638.html. The embassy/consulate will accept your application but not issue your visa more than 4 months before the date you are required to report to Washington Academy as shown on your Form I-20 or DS-2019. IMPORTANT! When you are issued your visa DO NOT use it to enter the U.S. more than 30 days before your program begins. You may be refused admission to the country or admitted as a B-2 tourist which prohibits you from attending school! U.S. Government officials want original documents. You must prepare papers to show the consul that prove why you are qualified for a student visa. Take all necessary documentation with you. Detailed information regarding this documentation may be found at: http://travel.state.gov/visa/temp/types/types_1238.html.

Make sure your passport is valid for at least one year in advance of your traveling to the United States.

Notify Agent and Washington Academy your Visa Interview results. IF YOUR VISA IS DENIED? Contact us with complete details of what was said and what documents you presented with your application. Send a copy of any written reason for the denial you may have been given. Washington Academy may be able to provide necessary documentation for your second interview.

Provide Washington Academy with flight information. Once your flight has been scheduled, we need to know. The nearest airport is located in Bangor, Maine (Airport Code BGR). We offer free pickup service to students who arrive within the arrival dates listed on the Transportation Calendar. If you travel outside of the travel dates provided, a nominal fee will be charged. For more information on our travel services please contact Mr. Philippe Gautier, Residential Life

Office Manager, at p.gautier@washingtonacademy.org or by telephone at (207)255-8301 ext. 228. Remember that Washington Academy is in the Eastern Time Zone, so please consider the time difference before you call. For students under the age of 15 that are traveling alone, the airlines are now requiring the parent/agent/person assisting with placing the student on the departing flight, information of whom will be picking up this student at the arrival destination. When this information is requested, please provide the airline with the following clause/information: "A representative of Washington Academy" will be picking this student up from the airport.

Now that you have your I-20, passport, visa and flight information you are ready to travel. REMEMBER TO CARRY ORIGINAL DOCUMENTS WITH YOU AT ALL TIMES!

Do not forget to bring your Washington Academy forms that needed signatures in your welcome packet and your immunization record. We are looking forward to seeing you at Washington Academy!

WWW.WASHINGTONACADEMY.ORG P.O. BOX 190, 66 CUTLER ROAD EAST MACHIAS, MAINE 04630 USA (207) 255-8301

IMPORTANT THINGS TO KNOW

We, as boarding school “parents” know that sending your child, regardless of age, away to school can be a dif�cult and emotional experience. We would like to make the transition as smooth as possible. Therefore, below you will �nd several hints and ideas to consider.

Items that your child will need to bring or purchase when he or she arrives:

Alarm clock

Radio

Stamps/Stationary

School Supplies (pens, pencils, notebooks, graphing calculator -TI-83 or 84, etc.)

Warm coat/Winter clothing

Warm waterproof boots

Laundry bag/soap

One set of formal wear for sit down dinners (shirt, tie, jacket, dress)

Bedspread/Comforter

Blanket/Comforter

Bed sheets (36”x80”)

Pillow

Towels & FaceclothsNon-internet electronictranslator

Rice Cooker

Griddle

Waf�e Iron

Hot Plate

Toaster Oven

Microwave

Small refrigerator

Computer

MP3/DVD Player

Items NOT allowed in dormitory rooms: Items allowed in dormitory rooms:

Please note that the voltage/wattage here is unlike yours, so your child may want to wait and purchase electrical items once he or she arrives. We will schedule shopping trips upon the student’s arrival. All academic books are supplied by the school free of charge. The question of how much spending money to send is always a dif�cult one. Our advice is that $20 to $25 a week is suf�cient. We discourage students from having large amounts of cash in their possession. Arrangements can be made at a local bank to accept wire transfers and open savings accounts, which they can draw upon. If you should have any questions or concerns while your child is attending Washington Academy, please feel free to contact your student’s dorm parent, or the Residential Life O�ce at (207) 255-8301, x. 228.

When sending mail to your student, please use the

following address:

(Your Student’s Name)Washington Academy

66 Cutler RoadP.O. Box 190

East Machias, Maine 04630

TOBACCO & ALCOHOL POLICY A reminder, that the possession or use of tobacco or alcohol products by Washington Academy students while on campus property, or while attending a school sponsored event, is prohibited. In Maine, it is illegal to possess or use tobacco products if one is under 18 years of age. Also in the State of Maine, it is illegal to possess or drink alcohol if one is under 21 years of age. Therefore, any student of Washington Academy in residence at the dormitory or with a host family is prohibited from possessing or using tobacco or possessing or drinking alcohol at any time. Students violating this policy will be subject to disciplinary actions.

WWW.WASHINGTONACADEMY.ORG P.O. BOX 190, 66 CUTLER ROAD EAST MACHIAS, MAINE 04630 USA (207) 255-8301

Summer Students arrive on campus: July 11-12, 2015; August 1-2, 2015

New Residential Life Student Orientation: August 29-31, 2015 (Must be on campus by August 28)

All New Students/Freshmen Day: September 2, 2015

All students-Opening Day: September 3, 2015

Christmas Vacation: December 19, 2015–January 3, 2016

Classes resume on January 4, 2016

February Vacation:

February 13 - 22, 2016Classes resume on February 23, 2016

April Vacation:

April 16-24, 2016Classes resume on April 25, 2016

Graduation:

June 6, 2016

Underclassmen Last Day:

June 17, 2016

Shuttles from the airport to Washington Academy will be o�ered on the following dates: Students who travel outside these dates will be charged according to set schedule of fees.

FALL STUDENT ARRIVAL August 27-28-New Students

CHRISTMAS DEPARTURE December 18 (after classes)-21, 2015

CHRISTMAS RETURN January 2-3, 2016

FEBRUARY DEPARTURE February 12 (after classes)-14, 2016

FEBRUARY RETURN February 20-21, 2016

APRIL DEPARTURE April 15 (after classes)-17, 2016

APRIL RETURN April 23-24, 2016 Seniors Depart June 6 (after Graduation)-June 8, 2016(All Seniors must attend graduation on June 6, 2016)

Underclassmen Depart June 17, 2016 (after exams)

I have read the information above; acknowledge the planned shuttle dates, and agree that I will be �nancially and academically responsible for any travel that does not fall within these dates, according to the attached policies.

______________________________________________ _______________

STUDENT SIGNATURE DATE

______________________________________________ _______________

PARENT SIGNATURE DATE

2015-2016 TRANSPORTATION CALENDAR

WA departures earlier than 5:30 am or WA arrivals later than 11:30 pm will incur additional cost.

Transportation for TOEFL testing o� site is NOT provided as this exam can be scheduled throughout the school year on campus at the WA site.

International Parent Reception: June 5, 2016

I understand that winter weather in Maine may cause school closings that will extend the school year beyond June 18, and I will be prepared to make the necessary adjustments to my student’s travel plans.

Spring Students arrive on campus: January 16-17, 2016Classes begin on January 20, 2016

SPRING STUDENT ARRIVAL January 16-17, 2016

August 31, Sept. 1-2-Returning Students

Calendar dates are subject to

change. We will try to

notify you in advance.

Please check our web site for updates.

WWW.WASHINGTONACADEMY.ORG P.O. BOX 190, 66 CUTLER ROAD EAST MACHIAS, MAINE 04630 USA (207) 255-8301

TERMS & CONDITIONS

All students enrolled at Washington Academy, and their parents or guardians, are asked to read these conditions carefully and sign at the bottom of this page. These rules have been developed over the years to ensure that all students enjoy a safe and successful experience.

Students are obligated to be aware of and follow the policies 1. and procedures of the school. Students are not entitled to a refund if they leave the school due to disciplinary issues.

Local and State laws in the U.S. prohibit high school age 2. students from purchasing or consuming alcohol.

This is a non-smoking program. Washington Academy 3. does not accept students who smoke tobacco products or marijuana, and neither is permitted at any time.

Controlled substances (illegal drugs such as marijuana, 4. cocaine, etc.) may not be taken, sold or bought by any student at any time for any reason.

Washington Academy program rules and insurance 5. restrictions prohibit the use of any motorized vehicle by students, except in the course of a licensed driver education class. Students may take part in such a class only with written permission from their natural parents or legal guardian.

No hitchhiking is allowed under any circumstances.6.

Students must maintain good academic standard in all 7. classes during their stay. This includes completing all coursework, demonstrating serious e�ort and a positive and cooperative attitude. School attendance is required. Absence is permitted only for cases of genuine illness with special permission from the school nurse or documentation from a doctor.

Students will be expected to pay all expenses for an 8. individual tutor if the student proves incapable of achieving academic success and maintaining passing grades.

The student’s personal property is not the responsibility of 9. Washington Academy. Any lost or stolen personal property of the student, including lost or stolen money, is the responsibility of the student, the student’s parents and or legal guardian.

Students may not make any life changing decisions while 10. enrolled at Washington Academy. This includes pregnancy, marriage, body piercing and tattoos.

Students who are charged with a violation of any federal, 11. state or local laws in the United States will be returned to their home country immediately at the expense of the parents or guardian.

If payment has not been made in full according to the 12. conditions of the enrollment agreement, I/we understand that I will not be allowed to sit for exams and that o�cial immigration authorities will be informed and my visa status will be cancelled.

I have read the rules above, understand them, and agree to follow them during my stay at Washington Academy. I understand that I will be subject to dismissal from the school if I fail to adhere to Washington Academy rules or if I am charged wit a violation of any U.S. Federal, State or local laws.

_______________________________________ ___________________________________ _____________STUDENT’ S SIGNATURE PARENT’ S SIGNATURE DATE

Students are responsible for any charges incurred (including, butnot limited to those that appear on the attached Residential FeeSchedule). Washington Academy may, at its discretion, charge thestudent’s Emergency Fund to cover any such charges.

13.

Students are required to establish an Emergency Fund withWashington Academy in an amount of no less than $1,250 (including the room deposit) at the beginning of each year. Shouldthe balance fall below $1,000, the student is required to replenishthe fund balance. Should an Emergency Fund reach a negativebalance, Washington Academy retains the right to charge interest on the negative balance at monthly interest rate of 1.5%.

14.

Washington Academy may require that students who incur ongoingexpenses (i.e. medical treatments, medication, counseling sessions)deposit additional funds in their Emergency Fund in anticipation ofthese costs.

15.

16. Students contracting to live in residence on campus do so for the entire school year. Changes in residence to o�-campus home stay mid-year will incur additional charges.

17. Students transferring to another school are not entitled to a refund. Students transferring before completion of a semester are not granted credit for classes not completed, including missed �nal exams.

18. Early termination from Washington Academy Washington Academy reserves the right to dismiss and send home any student whose mental or physical health (e.g. eating disorders, depression, chronic illness or condition) requires this action, or whose conduct is considered to be improper or o�ensive to the school community. Such conduct included, but is not limited to: illegal drug use, unacceptable sexual behavior, driving, drinking of alcoholic beverages, violation of the law, unsatisfactory school performance and or/ amicably in the residential and school setting. In the event the student is dismissed and returned home, the parents or guardian will be responsible for any additional expenses incurred. No refunds are made to families of students whose enrollment is terminated early for any of the above mentioned disciplinary reasons.

WWW.WASHINGTONACADEMY.ORG P.O. BOX 190, 66 CUTLER ROAD EAST MACHIAS, MAINE 04630 USA (207) 255-8301

TRAVEL/AUTOMOBILE PERMISSION FORM

No boarding student is permitted to drive unless enrolled in Driver Education Classes. During the course, they are only permitted to drive with the teacher.

No exceptions will be made to this rule.

I give permission for _______________________________________ to ride in automobiles as a guest of: STUDENT’S NAME

Sta�/Faculty: Yes No Day Parents: Yes No

Day Students: Yes No Host Family: Yes No

_______________________________________ ___________________________________ _____________SIGNATURE OF PARENT/ GUARDIAN PRINTED NAME OF PARENT/ GUARDIAN DATE

I give permission for _______________________________________

-to spend an overnight o� campus at an approved residence;

-to spend a weekend o� campus at an approved residence;

-to travel HOME unaccompanied during school holiday breaks, as per school transportation calendar;

-to travel unaccompanied to relatives in the US or other locales during school holiday breaks, as per school transportation calendar;

-to travel unaccompanied during school holiday breaks, as per school transportation calendar;

These permissions do not constitute approval to leave campus. The O�ce of Residential Life reserves the right to approve or deny o� campus day travel as well as extended travel requests.

By signing and authorizing the above permissions, I hereby release Washington Academy from all liability while my studentis away from campus.

STUDENT’ S

NAME

Yes No

Yes No

Yes No

Yes No

Yes No

Permission from parent/guardian is required for any travel, including travel as a result of the WA School Calendarvacation schedule. Please FAX permission with signature, travel dates, and destinations to Residential Life O�ce,1 (207) 255-8303; or provide scanned permission with signature, dates, and destinations through email to reslife@washingtonacademy.org.

WWW.WASHINGTONACADEMY.ORG P.O. BOX 190, 66 CUTLER ROAD EAST MACHIAS, MAINE 04630 USA (207) 255-8301

AUTHORIZATION TO TREAT A MINOR

I, (parent/guardian) the undersigned parent/guardian, or legal guardian of ______________________________, STUDENT’ S NAME

a minor, do hereby authorize and consent to any x-ray examination, anesthetic, or medical or surgical diagnosis rendered under the general or special supervision of any member of the medical sta� and emergency room sta� licensed under the provisions of the Medicine Practice Act, or a dentist licensed under the provisions of the Dental Practice Act and on the sta� of any acute general hospital holding a current license to operate a hospital.I also authorize and consent to supportive non-medical services which may include crisis intervention, supportivecounseling and/or psychiatric hospitalization rendered by a quali�ed mental health professional, or rendered underthe general supervision of a quali�ed mental health professional who is licensed and regulated under ME Title 32MRSA; Chapters 000119 & 000083.

It is understood that this authorization is given in advance of any speci�c diagnosis, treatment, or hospital care being required, but is given to provide authority and power to render care which the aforementioned physician, or other quali�ed professional, in the exercise of his best judgment may deem advisable. It is understood that e�ort shall be made to contact the undersigned prior to rendering treatment to the patient, but that any of the above treatment will not be withheld if the undersigned cannot be reached. Furthermore, I (parent/guardian) want to assure you that we will reimburse any expenditure not covered by the accident and sickness insurance policy.

Permission is granted for trained school personnel to dispense Tylenol®, Ibuprofen, Benadryl®

or an antacid when needed to my child. Written permission from a health care provider

is required for administration of other medications. Inhalers are an exception.

______________________________________________

_______________

SIGNATURE OF PARENT/ GUARDIAN

D ATE

List two neighbors or nearby relatives who will assume temporary care of your child if you cannot be reached:

__________________________________________ __________________ ( ______ ) _______- _________NAME R ELATI ONSHIP TO STUDENT TELE PHONE

__________________________________________ __________________ ( ______ ) _______- _________NAME R ELATI ONSHIP TO STUDENT TELE PHONE

This authorization to treat is to remain in e�ect unless otherwise noti�ed by written request from parent or guardian.

HEALTH RECORD INFORMATION

NAME: _____________________________________________________ SOCIAL SECURITY #: _______-_____-________ AGE: ______ SEX: M F

DATE OF BIRTH (M/ D/Y): _____ / _____ / ________ HOME PHONE: ( ______ ) _______-________ GRADE: ______

HOME ADDRESS: ___________________________________________________________ ______________________________ ________ _________ STREET ADDRESS CITY STATE ZIP

MOTHER’S NAME: ____________________________________________ MOTHER’S SOCIAL SECURITY #: _______-_____-________

MOTHER’S ADDRESS: ________________________________________________________ ______________________________ ________ _________ STREET ADDRESS CITY STATE ZIP

MOTHER’S WORK PHO NE: ( ______ ) _______-________ FATHER’ S WORK PHO NE: ( ______ ) _______-________

FATHER’S NAME: ______________________________________________ FATHER’ S SOCIETY SECURITY #: _______-_____-________

FATHER’S ADDRESS: _________________________________________________________ ______________________________ ________ _________ STREET ADDRESS CITY STATE ZIP

LEGAL GUARDIAN’S NAME: ____________________________________________ LEGAL GUARDIAN’S SOCIAL SECURITY #: _______-_____-________

LEGAL GUARDIAN’S ADDRESS: ___________________________________________________ ___________________________ ________ _________ STREET ADDRESS CITY STATE ZIP

LEGAL GUARDIAN’S WORK PHO NE: ( ______ ) _______-________

IN CA SE OF A N EMERGENCY CO NTACT: _______________________________________ RELATIONSHIP: (I.E. FRIEND/RELATIVE, ETC.) _______________

EMERGENCY CONTACT WORK PHONE: ( ______ ) _______-________ HOME PHONE: ( ______ ) _______-________

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -IMMUNIZATION RECORDS

Records need to be authorized by a 1. physician or a photocopy of school health records is acceptable.State law requires all students to be fully immunized before attending school.2. No student will be admitted to Washington Academy without adequate immunizations being proven.3. Proper immunizations includes: 4 doses of D PT MMR : 2 doses. Oral Polio: 4 doses4. NO STUDENT CAN BEGIN CLASSES WITHOUT PROPER IMMUNIZATION DOCUMENTATION.5.

DPT series (m/d/y): 1st ____ / ____ / _______ 2nd ____ / ____ / _______ 3rd ____ / ____ / _______ 4th ____ / ____ / _______

OPV/IPV (m/d/y): 1st ____ / ____ / _______ 2nd ____ / ____ / _______ 3rd ____ / ____ / _______ 4th ____ / ____ / _______

Hepatitis B (HBV) (m/d/y): 1st ____ / ____ / _______ 2nd ____ / ____ / _______ 3rd ____ / ____ / _______

MMR1 (m/d/y): ____ / ____ / _______ MMR2 (m/d/y): ____ / ____ / _______

TB test or Chest x-ray in the past year: ____ / ____ / _______ DT – date of last shot (due every ten years): ____ / ____ / _______

Varicella Immunization : ____ / ____ / _______ If not immunized, date of Disease: ____ / ____ / _______

Varicella Disease is veri�ed by your signature and is required by United States Law

By signing this form you are verifying that this student is in good physical health and can participate in sports.

______________________________________________ ____________________________________________ ________________PHYSICIAN’S NAME (PLEASE PRINT) PHYSICIAN’S SIGNATURE DATE

_________________________________________________________ ____________________________ ________ __________STREET ADDRESS CITY STATE ZIP

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -PHYSICAL HEALTH

Medical/Surgical History: ________________________________________________________________________________________

_______________________________________________________________________________________________________________

Allergies: Yes No If yes, please specify: _______________________________________________________________________

Medications: Yes No If yes, please specify: ___________________________________________________________________

Please list any health problems you have or may have had in the past: ______________________________________________________

_______________________________________________________________________________________________________________

_______________________________________________________________________________________________________________

continued on back

HEALTH RECORD INFORMATION, continued

MENTAL HEALTHIs your child currently receiving or have received in the past, counseling services? .................................................................................... Yes No

If so, when and with whom?

____ / ____ / _______ ______________________________ _______________________________________________________DATE (M/D/Y) NAME A DDRESS

Is this a service you wish to continue? .......................................................................................................................................................................................... Yes No

Is your child now or in the past taking medication related to mental health needs? ................................................................................ Yes No

If yes, what is the name of the medication? ___________________________________________________ Dosage? ______________

How long has your child been taking this medication? ________________________________________

Has you child ever experienced depression or attempted suicide? ................................................................................................................. Yes No

If yes, when? __________________ How was the situation handled? __________________________________________________

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - DENTAL HEALTH

All necessary dental work must be done prior to coming to school. A clean bill of dental health must accompany the health records.

_________________________________________________________ ( ______ ) _______-________DENTIST’S NAME DENTIST TELEPHONE

_________________________________________________________ ____________________________ ________ __________DENTIST’S ADDRESS CITY STATE ZIP

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -INSURANCE INFORMATION

Please send a copy (front and back) of your current insurance card.

PRIMARY INSURANCE: ______________________________________________________________ Is this an HMO? Yes No COMPANY NAME

( ______ ) _______-________ _________________________________________________ ___________________ ______ ________COMPANY TELEPHONE COMPANY STREET ADDRESS CITY STATE ZIP

_____________________________________________ _____________________________ ________________________________SUBSCRIBER GROUP # I.D. #

_________________________________ ______________________________________ ___________________ ______ ________EMPLOYER EMPLOYER ’S STREET ADDRESS CITY STATE ZIP

SECONDARY INSURANCE: ________________________________________________________________________________________ COMPANY NAME

_________________________________________________________ ____________________________ ________ __________COMPANY STREET ADDRESS CITY STATE ZIP

_____________________________________________ _____________________________ ________________________________SUBSCRIBER GROUP # I.D. #

_________________________________________________________ ( ______ ) _______-________FAMILY PHYSICIAN ’S NAME FAMILY PHYSICIAN ’S TELEPHONE

_________________________________________________________ ____________________________ ________ __________FAMILY PHYSICIAN ’S ADDRESS CITY STATE ZIP

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -PARENT PERMISSION DECLARATION

I authorize designated school personnel to act as my child’s guardian for the entire school year.

I give consent for my child to participate in and be treated for any injuries in the event of an emergency.

I authorize the use of anesthesia and blood products if necessary in the event of an emergency, operation, or treatment in an accredited hospital.

I authorize trained school personnel to administer medications to my child as needed.

I give consent for the administration of necessary immunizations required by Maine State law that my child has not received prior to enrollment. I understand I will be charged accordingly by the school physician.

These consents and declarations will discontinue upon my child’s withdrawal.

_______________________________________________ ___________SIGNATURE OF PARENT/ GUARDIAN DATE

APPENDIX W

MPA TRANSFER WAIVER APPROVAL FORM

This form is to be processed when a student transfers from one school to another without a corresponding change of legal residence of both the student and parent/guardian and wishes to participate in interscholastic athletics within one year of the transfer (MPA By-Laws, Article III, Section 4). The process and responsibilities are as follows:

1. Either PRINCIPAL may initiate the process. The second PRINCIPAL shall sign the form, if in agreement, and forward it to the MPA Executive Director for approval.

2. The transferring student is eligible the day this form is approved by the MPA Executive Director, provided that it is prior to the start of the sports season.

I hereby certify that _____________________________________has transferred from (please print name of student, first and last)

___________________________ , located in _________________, ______________. (Name of Sending School) (State) (Country)

He/she has transferred to ________________________________, and will be entering (Name of Receiving School)

grade ________________as of ____________________and to the best of my (9, 10, 11, or 12) (Date of Enrollment – month, day, year)

knowledge the student has not transferred primarily for athletic purposes (see MPA By-Laws, Article III, Section 4, Subsection A, Paragraph 3).

By signing this form as the sending principal, I agree that to my knowledge the student has not transferred primarily for athletic purposes.

Sending Principal’s Signature:_________________________________ Date:______

By signing this form as the receiving principal, I agree that to my knowledge the student has not transferred primarily for athletic purposes.

Receiving Principal’s Signature: _______________________________ Date:______

WHEN COMPLETED, PLEASE SEND THIS FORM TO THE MPA (FAX - 207-622-1513 OR E-MAIL mpa@mpa.cc)

***FOR MPA USE ONLY***

This request for a waiver of the Transfer Rule is:

____Granted By: MPA Executive Director_____________________Date:____________

____Referred to the Eligibility Committee: ____Granted _____Denied Date:_____

Notification emailed to receiving school on:_______________________

MPA TRANSFER WAIVER FORM

Admission Procedures

Washington Academy believes that �nding a secondary school that is a “right �t” for you is one of the most important educational decisions you will make. You’ve done your homework by researching schools. Now it is our turn to ensure that our academic programs and extracurricular activities will bene�t you. We do this by carefully reviewing your academic background and the references you have provided in this application packet. Personal interviews by phone or visit are strongly encouraged because they give us a better opportunity to get to know you. Based on these criteria, we make a decision on your admission to Washington Academy .

Washington Academy has a “rolling” admission policy. This bene�ts you in that you are not waiting around for a speci�c date in order to receive noti�cation on your admission. We will notify you as soon as all your information has been received and reviewed. You know you have completed all the requirements, when you have checked o� each of the following three boxes:

Completed and returned the application with a non-refundable $50 application fee and a picture of yourself.

Provided your teachers and counselors with the enclosed recommendations and asked them to mail the forms directly to us.

Arranged to have your current school send us a copy of your current transcripts and standardized test scores.

We know that �lling out this application takes a great deal of time and thought. We appreciate all your e�ort. We look forward to reviewing your materials and getting to know you.

Please mail your Application to: Robin Molo�-Gautier, Director of Admissions and Residential Life 66 Cutler Road, PO Box 190 East Machias, ME 04630

Or fax to: 207-255-8303

Washington Academy does not discriminate on the basis of race, sex, age, sexual preference, disability, religion or ethnic origin in its admission policies.Washington Academy is accredited by the New England Association of School and Colleges and is approved by the Maine Department of Educational and Cultural Services.

123

APPLIC ATION

Applicant Information:

_____________________________________ ____________________________ ______________________ __________________ ______________ Home Address City State/Province Country Zip Code

_______________ ____________________________ ________________________ ________________________ Age Date of Birth (Mo/Day/Year) Country of Birth Country of Citizenship

_______________________ ____________________________ ___________________________________ ___________________________________ Social Security Number E-mail Address Home Telephone (with country code & area code) Fax Number (with country code & area code)

Applicant Test Information:Applicant has taken __________ SSAT __________ IELTS __________ Jr. TOEFL __________ TOEFL _______SLATE-Plus

Intended Program of Study:

English as a Second Language: Y N Special Services: Y N Month/Year/Grade of proposed entrance

_________________________________________________________ ________________ ________________ _______________________________ Current School Current Grade Entering Grade School Phone

_____________________________________ ____________________________ ______________________ __________________ ______________ School Address City State/Province Country Zip Code

Financial Aid Information: Will you be applying for �nancial aid? Y N

Tell us about yourself:

We attempt to place you in housing according to your preference. I prefer: Dormitory Host Home

C urrently, I am involved in the following extracurricular activities: _____________________________________________________

__________________________________________________________________________________________________________________________________

One thing I like about myself: ______________________________________________________________________________________________

__________________________________________________________________________________________________________________________________

One thing I would like to improve about myself: _________________________________________________________________________

_________________________________________________________________________________________________________________________________

Washington Academy currently o�ers the following sports. Please circle those that you would like to participate in. Soccer Basketball Baseball Swimming Volleyball Cheerleading Softball Football Golf Tennis Cross Country Wrestling

Applicant: Sex: M F

__________________________________ ___________________________ __________________________________ First Name Middle Name Last Name

Attach a current

photo of yourself

Please write an essay (less than 250 words) answering the following two questions. 1. What is the most important thing you hope to gain from attending Washington Academy? 2. What is the most important contribution you can make to our school?

/ /

in which of the following school activities would you like to participate? Please circle. Chess Team Student Newspaper Student Council Yearbook Student Literary Magazine Public Speaking Theater Digital Video Club Art Creative Writing Jazz Band Pep Band Concert Band Chorus Yoga Musical Festivals Academic Decathlon National Honor Society Envirothon Intramural sports Science Outings International Club Student Librarians Prom Skiing

As part of dorm life, Washington Academy offers the following weekend and evening activities. Please check those in which you would be interested in participating: ______ Membership at the Learning Center at the University of Maine at Machias (pool, weight room and gym) ______ Mountain Biking ______ Hiking ______ Whale Watching ______ Whitewater Rafting ______ Skiing ______ Camping ______ Shopping ______ Trips to Boston, MA ______ Trips to cities in Maine

Other activities I am interested in doing: ____________________________________________________________________________________________

Parent/Guardian information:Please have your parent or guardian fill out the following information.

_______________________________________________________________ _______________________________________________________________ Father’s Name or Male Guardian’s Name Mother’s Name or Female Guardian’s Name

_______________________________________________________________ _______________________________________________________________ Home Address Home Address

_______________________________________________________________ _______________________________________________________________ City State/Province Country Zip City State/Province Country Zip

_______________________________________________________________ _______________________________________________________________ Home Phone Fax Home Phone Fax

_______________________________________________________________ _______________________________________________________________ Home e-mail Home e-mail

_______________________________________________________________ _______________________________________________________________ Business Name Occupation Business Name Occupation

_______________________________________________________________ _______________________________________________________________ Business Address Business Address

_______________________________________________________________ _______________________________________________________________ City State/Province Country Zip City State/Province Country Zip

_______________________________________________________________ _______________________________________________________________ Business Phone Fax Business Phone Fax

_______________________________________________________________ _______________________________________________________________ Business e-mail Business e-mail

_______________________________________________________________ _______________________________________________________________ Contact’s Name Contact’s Relationship to You

_______________________________________________________________ _______________________________________________________________ Address City State/Province Country Zip

_______________________________________________________________ _______________________________________________________________ Home Phone Fax Work Phone Fax

_______________________________________________________________ _______________________________________________________________ Home e-mail Work e-mail

Signatures:_______________________________________________________________ __________________________________ Parent or Guardian Signature Date

_______________________________________________________________ __________________________________ Applicant Signature Date

$50 application fee enclosed

Y N

if your parents do not speak English, or do not have an e-mail address, please indicate an alternate English speaking contact to represent your family.

counselor Recommendation

Name of Applicant ____________________________________________________________________________________________________________

Present School ___________________________________________________ Present Grade ____________________________________________

Authorization of ReleaseParents: Under the Family Educational Rights and Privacy Act of 1974, the undersigned hereby consents to the release of all educational records of the above named applicant to Washington Academy.

Parent Signature ____________________________________________________________________ Date ____________________________________

to the Guidance counselor:The student named is a candidate for admission to Washington Academy. In order to make an accurate assessment, we would like for you to provide us with a transcript of the student’s academic record and a copy of any standardized tests the student has taken. In addition, please make a personal assessment of the student’s social awareness, motivation, and academic ability by filling out the following chart.

One of the top Excellent Very Good Good Below few I have ever (top 10% (well above (above average) Average Average encountered this year) average)

intellectual level

Verbal Ability

Social Maturity

Moral Responsibility

Organizational Skills

Daily Preparation

class Participation

leadership

Relations with Peers

Abides by Rules

Emotional Stability

concern for Others

counselor Recommendation (cont.)

How long have you known the applicant and in what capacity?

We welcome any additional remarks. You may use this space to comment further on this candidate’s strengths, weaknesses, or personal characteristics.

i REcOMMEnD tHiS cAnDiDAtE FOR ADMiSSiOn tO WASHinGtOn AcADEMY.

Signed ________________________________________________________________ Date ____________________________

Print Name ____________________________________________________________

School Address _____________________________________________________________________________________________

Please return to:

AdmissionsWashington Academy66 Cutler Road, P.O. Box 190East Machias, ME 04630

Phone: (207) 255-8301, ext. 207nFax: (207) 255-8303nE-mail: admissions@washingtonacademy.org

www.washingtonacademy.org

Academically

Personally

Highly Without Hesitation With Hesitation Not Recommended Comments

Math Teacher Recommendation

Name of Applicant ____________________________________________________________________________________________________________

Authorization of ReleaseUnder the Family Educational Rights and Privacy Act of 1974, I ______ waive ______ do not waive any right ofaccess to this recommendation.

Applicant’s Signature _____________________________________________________ Date _________________________

C omment on the student’s reading comprehension and ability to express themselves in writing. _______________

__________________________________________________________________________________________________________

__________________________________________________________________________________________________________

How has the student performed in relation to potential? ____________________________________________________

__________________________________________________________________________________________________________

__________________________________________________________________________________________________________

One of the top Excellent Very Good Good Below few I have ever (top 10% (well above (above average) Average Average encountered this year) average)

I ntellectual L evel

Verbal Ability

Social Maturity

Moral Responsibility

Organizational Skills

Daily Preparation

C lass Participation

L eadership

Relations with Peers

Abides by Rules

Emotional Stability

C oncern for Others

Math Teacher Recommendation (cont.)

How long have you known the applicant and in what capacity?

We welcome any additional remarks. You may use this space to comment further on this candidate’s strengths,

weaknesses, or personal characteristics.

Next year, what math course would be the most appropriate placement for the student?

Basic First Year Algebra First Year Algebra (including quadratics) Geometry Second Year Algebra Second Year Algebra (including trigonometry) Pre-Calculus Calculus AP Calculus AB BC

Signed ________________________________________________________________ Date ____________________________

Print Name ____________________________________________________________

School Address _____________________________________________________________________________________________

Please return to:

AdmissionsWashington Academy66 Cutler Road, P.O. Box 190East Machias, ME 04630

Phone: (207) 255-8301, ext. 207 � Fax: (207) 255-8303 � E-mail: admissions@washingtonacademy.org

www.washingtonacademy.org

Academically

Personally

Highly Without Hesitation With Hesitation Not Recommended Comments

I RECOMMEND THIS CANDIDATE FOR ADMISSION TO WASHINGTON ACADEMY.

English teacher Recommendation

Name of Applicant ____________________________________________________________________________________________________________

Authorization of ReleaseUnder the Family Educational Rights and Privacy Act of 1974, I ______ waive ______ do not waive any right ofaccess to this recommendation.

Applicant’s Signature _____________________________________________________ Date _________________________

comment on the student’s comprehension and ability in relation to your subject area. ________________________

__________________________________________________________________________________________________________

__________________________________________________________________________________________________________

How has the student performed in relation to potential? ____________________________________________________

__________________________________________________________________________________________________________

__________________________________________________________________________________________________________

One of the top Excellent Very Good Good Below few I have ever (top 10% (well above (above average) Average Average encountered this year) average)

intellectual level

Verbal Ability

Social Maturity

Moral Responsibility

Organizational Skills

Daily Preparation

class Participation

leadership

Relations with Peers

Abides by Rules

Emotional Stability

concern for Others

English teacher Recommendation (cont.)

How long have you known the applicant and in what capacity?

We welcome any additional remarks. You may use this space to comment further on this candidate’s strengths, weaknesses, or personal characteristics.

i REcOMMEnD tHiS cAnDiDAtE FOR ADMiSSiOn tO WASHinGtOn AcADEMY.

Signed ________________________________________________________________ Date ____________________________

Print Name ____________________________________________________________

School Address _____________________________________________________________________________________________

Please return to:

AdmissionsWashington Academy66 Cutler Road, P.O. Box 190East Machias, ME 04630

Phone: (207) 255-8301, ext. 207nFax: (207) 255-8303nE-mail: admissions@washingtonacademy.org

www.washingtonacademy.org

Academically

Personally

Highly Without Hesitation With Hesitation Not Recommended Comments

About Washington AcademyAs one of the oldest academies in Maine, Washington Academy (WA) has been meeting the educational needs of students in grades 9-12 since the school’s charter was signed by John Hancock in 1792. Originally a feeder school for Bowdoin College in the early 1900s, the Academy continues to emphasize on academics and success for each individual. Taking into account each student’s differences, Washington Academy strives to create opportunities that prepare students socially and intellectually for their future endeavors. The curriculum is based upon college preparation, but it is also flexible enough for the student who seeks a quality education that includes business, technology education, and vocational studies. Emphasis is placed on the performing and visual arts, math and sciences, and involvement in the community.

LocationWashington Academy’s 55-acre campus is located in a safe, rural community in coastal Downeast Maine. The location enhances the nurturing environment created by a low student-teacher ratio, individualized attention, and a welcoming community. Just two miles from the Atlantic Ocean, the area also provides excellent rec-reational opportunities, including kayaking, sailing, fishing, hiking and nature walks. In 2010-2011 a new fine arts center was built and provides additional dedicated space for the Arts and Music Programs.

Academic CurriculumWashington Academy is organized on a block schedule. Four cred-its per semester is the maximum course load; students take four 80-minute block classes per day during each semester. There are two semesters each academic year. Students are required to enroll in at least six credit hours per year.

A minimum of 23 credits is required for graduation. Graduation requirements include: 4 credits in English; 3 credits in Mathemat-ics for the class of 2014, the class of 2015 and beyond will require 4 credits in Mathematics; 3 credits in science including 1 credit in Biology and 1 credit in Chemistry; 3 credits in Social Studies including 1 credit in US History, ½ credit in Civics, and ½ credit in Introduction to Social Science; 1 credit in Physical Education; 1 credit in Fine Arts; ½ credit in Health and 1 credit in Advisor/Advisee.

The following Advanced Placement (AP) courses are offered on an alternating basis: AP Language & Composition, AP English Litera-ture & Composition, AP Calculus AB, AP Calculus BC, AP Biology, AP Chemistry, AP Statistics, AP Physics, AP United States History, AP European History, AP Latin, AP Spanish, AP Studio Art, and AP Music Theory.

Husson University courses are taught on campus on an alternating basis with the option for dual-credit. The following Husson courses are offered at Washington Academy: Husson English 1, Husson Anatomy & Physiology, Husson Algebra, Husson Probability & Statistics, Husson Sociology, Husson Psy-chology, and Husson History of Western Civilization.

Honors classes are offered in English, Algebra, Geometry, Integrat-ed Science, Biology, Chemistry, World History, and United States History.

Students are provided many choices for electives, including many fine arts courses, music composition, concert chorus, studio art, and computer aided drafting (CAD). Other electives include our certified nursing assistant (CNA), Advanced Placement courses, foreign languages (Spanish, Chinese, Latin, and Conversational French), coastal ecology, and internships including an exploratory course in health occupations at a local hospital. Vocational courses are also available to all students.

The curriculum includes English as a second language (ESL). Students are provided with basic, intermediate, and advanced ESL. International students are integrated into classes within the regular curriculum.

Grading and RankingA = Excellent Work B = Above Average Work(Highest Honors) (High Honors)A+ = 98-99 B+ = 91-92 A = 95-97 B = 88-90 A- = 93-94 B- = 85-87 C = Average Work D = Below Average Work C+ = 82-84 D+ = 74-75C = 79-81 D = 72-73C- = 76-78 D- = 70-71Below 70 = Failing work and no credit is given.

For special subjects:S = Satisfactory Work U = Unsatisfactory Work

RankClasses are weighted for the purposes of class rank according to the rigor of the course.

Grade Point Average (GPA) CalculationGPA is unweighted and computed using above quality points. Beginning with grade nine, all academic subjects, whether passed or failed, are included in the computation of the GPA. Grades are recorded on the transcript and GPA is computed in January and June.

CEEB 200330

Guidance Staff(207) 255-8301 EXT. 212

Valerie Renshaw, Director of GuidanceStephanie Seeley, Guidance Counselor

Joanne Ausprey, College Placement CounselorJunia Lehman, Registrar

AthleticsWashington Academy promotes sports and activities as an integral part of the educational process. Team sports include baseball, basketball, cheerleading, cross-country, football, golf, soccer, softball, swimming, tennis, volleyball, track and field, and wrestling. Washington Academy competes with both private and public schools in the area. Washington Academy has competed in many eastern Maine and state championships. Athletic fields occupy the rear portion of the campus and consist of soccer, football, baseball, and softball fields. Washington Academy has a wooded cross-country trail that covers blueberry fields and ascends a notoriously difficult hill. Four new tennis courts are in the construction phase and a health/wellness center was created and is available on campus for student and faculty use.

Boarding and General FacilitiesWashington Academy currently operates three boarding fa-cilities. The Talbot dormitory is the newest dormitory, having opened in December 2006, and houses 48 boys. The Larson dormitory houses up to 12 boys. The Edwin and Linnie Cates dormitory, with its recent sixteen-bed addition, has the capacity to house 32 girls. Washington Academy employs residential faculty to supervise the facilities and be dorm parents to the residents. Washington Academy also operates an active host home placement program for both boys and girls. Families in the program have been carefully screened and matched with incoming students.

Awards and Distinctions, 2013-2014

• 1 PSAT National Merit Commended Student• 1 Claes Nobel Educator of Distinction

Enrollment Information 2014 Total enrollment (9-12) 375 Seniors 91

Student Ethnic Distribution

Caucasian 78%

Asian 13%

Black/African American 4%

Native American 3%

Hispanic 2%

Post High School Placement, 2014

76% matriculated to 4-year colleges19% matriculated to 2-year colleges7% selected military service or work force Class of 2014 Average GPA: 90.04

Colleges Attended by Washington Academy Students Include: Adelphi UniversityBinghamton University Boston College Boston University Bowdoin College Brandeis University Brown UniversityBryant University Bryn Mawr College Carleton UniversityCarnegie Mellon UniversityCase Western Reserve U.Colby College Columbia UniversityCornell UniversityDalhousie UniversityDartmouth College DePaul University Dickenson CollegeDrexel University Eastern Maine College Endicott College Fisher College Florida Technical School Florida Institute of Technology

Fordham UniversityGeorge Washington University Georgia Technical InstituteGrossmont College Harvard College Husson University Indiana UniversityIowa State University Ithaca CollegeKeene State CollegeKeystone Technical Institute Lehigh UniversityMaine Maritime Academy Marquette UniversityMass. Institute of TechnologyMiami UniversityMichigan State UniversityMiddlebury CollegeMount Ida College New England College NE School of CommunicationNew York University Northeastern University Northern Michigan University Ohio State UniversityPace UniversityParson’s New School for Design Penn State UniversityPortland State University

Princeton UniversityPurdue UniversityQuinnipiac UniversityRensselear Polytechnic InstituteRITRoger Williams University Rutgers University San Francisco Art InstituteSavannah College of Arts & DesignSkidmore College Smith CollegeSouthern Illinois UniversitySouthern Maine CollegeSt. Lawrence University St. Joseph’s College St. Louis University-Madrid Stanford UniversityStony Brook UniversitySyracuse UniversityTemple UniversityThomas College Tufts UniversityUniversal Technical Institute University of AlabamaUniversity of ArizonaUniversity of BuffaloUniversity of CincinnatiUniversity of Connecticut

University of IdahoUniversity of IowaUniversity of Illinois-UCUniversity of Illinois-ChicagoUniversity of Maine at Augusta University of Maine at Machias University of OregonUniversity of Maine at Orono University of MassachusettsUniversity of PennsylvaniaUniversity of Oregon University of San FranciscoUniversity of Southern Maine University of TennesseeUniversity of Texas at Austin University of Texas at SAUniversity of MiamiUniversity of UtahUniversity of Vermont University of WisconsinUrsinus College Vanderbilt UniversityVassar CollegeVermont Technical CollegeVirginia Commonwealth U.Virginia Tech Western New England College Wesleyan University-IllinoisWheaton College

Since 1792

For More Information, Please Contact: Admissions Of�ce, Washington AcademyPO Box 190, 66 Cutler Road • East Machias, Maine USA 04630 • 207.255.8301 ext. 207

E-mail: admissions@washingtonacademy.org

www.washingtonacademy.org

• Safe 65 Acres• Comfortable Dormitories• College Preparatory Classes• AP Classes• Early College Courses• International Business Program• Latin, Spanish, French, Chinese• Knowledgeable Teachers• Full English Language Learner Curriculum• Wireless Campus• Career and Leadership Tracks• Residential Curriculum• Summer English Language/Soccer Institute• Athletics, State Title Teams• Friendly People• Fall and Spring Semester Enrollment• Grades 9-12, PG