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The International School of Kraków

Lusina ul. Św. Floriana 57, Kraków 30-698 Tel/ Fax: +48 12 270 14 09 E-mail: school@iskonline.org On the Web: www.iskonline.org

Student’s name ___________________________________________ Grade ____________

ISK ADMISSION CHECKLIST Please complete, sign and submit the following forms included in the admissions packet:

 APPLICATION FOR ADMISSION  PHOTOCOPY OF CHILD’S PASSPORT OR BIRTH CERTIFICATE  STUDENT MEDICAL FORM – to be completed before the first day of school; the examination is valid six months prior to admission

 REQUEST FOR TRANSCRIPTS  LANGUAGE INTEREST SURVEY  PHYSICAL EDUCATION QUESTIONNAIRE  CONTRACT

ADMINISTRATIVE USE ONLY

Grade _____________ ______ Accepted ______ Waiting list ______ Rejected Pending

 School records

 Health form

 Copy of resident permit/passport

 Test results  Other documentation

Administrator’s Name __________________ Date _______________ ISK Admission Packet - 1 -


The International School of Kraków

Lusina ul. Św. Floriana 57, Kraków 30-698 Tel/ Fax: +48 12 270 14 09 E-mail: school@iskonline.org On the Web: www.iskonline.org

APPLICATION FOR ADMISSION For the Academic Year ___________- __________ Expected entry date_________ Expected length of stay_________

PERSONAL DATA OF CHILD Student's family name ___________________________________ First name(s) __________________________________________ Date of birth

Day _________Month ________Year __________

Place of birth___________________________________________ Passport number________________________________________ PESEL number (if available) ______________________________ Citizenship ____________________________________________

(Please attach recent photograph here)

Original nationality______________________________________ Sex ________________ Current grade ______________________ Native language(s) ______________________________________ Other languages spoken __________________________________ ADDRESS Permanent address in Krakow area: Street ______________________________________ Postal code ______-___________ City _______________________________________ Tel. ________________________ Address for immediate correspondence (if different from permanent address): Street_______________________________________ Postal code ______-___________ City_________________________________________Tel.________________________ ISK Admission Packet - 2 -


The International School of Kraków

Lusina ul. Św. Floriana 57, Kraków 30-698 Tel/ Fax: +48 12 270 14 09 E-mail: school@iskonline.org On the Web: www.iskonline.org

PERSONAL DATA OF PARENTS/GUARDIANS (For School Directory and internal use only) Mother's family name _________________

Father's family name _________________

First name _________________

First name _________________

Nationality _________________

Nationality _________________

Occupation _________________

Occupation _________________

Employer's name _________________

Employer's name _________________

Employer's address _________________

Employer's address _________________

Street _________________

Street _________________

Postal code ________ City ___________

Postal code ________ City ___________

Tel ____________ Fax ____________

Tel ____________ Fax ____________

Mobile _________________

Mobile _________________

E-mail _________________

E-mail: _________________

EMERGENCY CONTACTS Please provide the names and telephone numbers of emergency contact persons if parents/guardians are not available.

Contacts (other than Parents/Guardians) Name________________________Tel. __________________Mobile________________________ Name________________________Tel. __________________Mobile________________________ Name________________________Tel. __________________Mobile________________________

ISK Admission Packet - 3 -


The International School of Kraków

Lusina ul. Św. Floriana 57, Kraków 30-698 Tel/ Fax: +48 12 270 14 09 E-mail: school@iskonline.org On the Web: www.iskonline.org

PREVIOUS SCHOOLING

Name of school

Address

Dates attended

School records submitted

SIBLINGS Family Name

First name

Date of birth

Current school

Has your child ever been referred or tested by outside agencies (e.g. Child Guidance, Clinic, learning, speech, psychological assessments, etc.)? YES NO

 

(if yes, please attach documentation)

PLEASE CHECK THE BOXES THAT APPLY

 I DO  I DO NOT authorize the use of my child's photograph for school publications and promotional materials with no names attached

 I DO

 I DO NOT give permission to publish our address/telephone number in the ISK Telephone Directory used only by members of the the ISK Community _________________________ Signature of Mother/Guardian

__________________________ Signature of Father/Guardian

______________________ Date

______________________ Date

ISK Admission Packet - 4 -


The International School of Kraków

Lusina ul. Św. Floriana 57, Kraków 30-698 Tel/ Fax: +48 12 270 14 09 E-mail: school@iskonline.org On the Web: www.iskonline.org

REQUEST FOR TRANSCRIPTS Previous Educational Institution: School Name:

__________________________________

School Address:

__________________________________

City, Zip Code, Country:

__________________________________

Telephone Number:

__________________________________

Fax Number:

__________________________________

Contact Person/Title:

__________________________________

Student, ________________________, will be attending The International School of Krakow in academic year __________. We formally request a copy of all student records to be sent to the following address: The International School of Krakow Attn: Administrative Officer Lusina ul. św. Floriana 57, Krakow 30-698 Tel/Fax: +48 12 270 14 09

The timely receipt of these materials is vital to the continuity of continued education of the above named student. Thank you for your cooperation.

_________________________________ Parent/Guardian’s Signature Date

ISK Admission Packet - 5 -


The International School of Kraków

Lusina ul. Św. Floriana 57, Kraków 30-698 Tel/ Fax: +48 12 270 14 09 E-mail: school@iskonline.org On the Web: www.iskonline.org

STUDENT MEDICAL FORM

PART I

Student’s name: _________________ Grade: _____ Sex: M  F  Date of birth: __________________ (month/day/year) IMMUNIZATION RECORD

(Provide Dates- month, day, year or copy of your child’s immunization card) ) PERTUSIS DIPHTHERIA TETANUS POLIO MEASLES MUMPS RUBELLA

TB TEST HEPATITIS

A

HEPATITIS

B*

** BCG OTHER

* Hepatitis B is highly recommended in Poland ** If BCG done more than five years ago a TB test or chest x-ray is required

ISK Admission Packet - 6 -


The International School of Kraków

Lusina ul. Św. Floriana 57, Kraków 30-698 Tel/ Fax: +48 12 270 14 09 E-mail: school@iskonline.org On the Web: www.iskonline.org

MEDICAL HISTORY Student’s Name:_________________________________________ Allergies:________________________________________________________________________ Dietary Restrictions: Food Allergy

Reaction/s

Treatment

Past Medical History:______________________________________________________________ Chronic Medical Conditions:________________________________________________________ Current treatment (daily medications):_________________________________________________ Permission for Medication Administration at School My child, ______________________________ may receive Tylenol (acetaminophen), Panadol, Ibuprofen, cough drops or throat lozenges at school if needed. Yes  No  ______________________________________________________________________________ (Parents/legal guardian’s signature) Does your child wear any of the following? Glasses  Contact Lenses Hearing Aids  Removable Dentures or Plates  Braces (on teeth) other ________________________________________________________________________ Medical Insurance: _____________________________________________________________

_____________________________________ Parent/Guardian’s Signature Date ISK Admission Packet - 7 -


The International School of Kraków

Lusina ul. Św. Floriana 57, Kraków 30-698 Tel/ Fax: +48 12 270 14 09 E-mail: school@iskonline.org On the Web: www.iskonline.org

PHYSICAL EXAMINATION PART II Student’s name:_________________________________ Date of birth: __________________ (month/day/year) Height _______cm

Weight _______kg

Blood pressure ______ mmHg

EXAMINATION (√ for any problems and explain) Eyes  __________________________________________________ Ears

__________________________________________________

Nose, throat

__________________________________________________

Oral cavity, teeth

__________________________________________________

Respiratory track

__________________________________________________

Heart, circulatory system

__________________________________________________

Genito-urinary

__________________________________________________

Neurological

__________________________________________________

Musculoskeletal

__________________________________________________

Spine (curvature or other)

__________________________________________________

Extremities

__________________________________________________

Feet (flat, torsion, etc.)

__________________________________________________

Gait

__________________________________________________

Abdomen

__________________________________________________

Skin (rashes, eczema, etc.)

__________________________________________________

Development for age

__________________________________________________

Nutritional status

__________________________________________________

Mental/behavioral status

__________________________________________________

Speech

__________________________________________________

Overall appraisal of health, capabilities, limitations: ______________________________________ ________________________________________________________________________________ Recommendations: I have examined the person herein described and have reviewed the health history, as recorded above. It is my opinion that this person physically able to engage in all school activities, except as noted above.

_________________________________________ Signature and Doctor’s Stamp Date ________________________________________ Print name ISK Admission Packet - 8 -


The International School of Kraków

Lusina ul. Św. Floriana 57, Kraków 30-698 Tel/ Fax: +48 12 270 14 09 E-mail: school@iskonline.org On the Web: www.iskonline.org

LANGUAGE INTEREST SURVEY Student’s name _____________________

Grade _____________

All classes at ISK are taught in English, including Art and Music. Foreign and Native language offerings are determined based on interest, staffing capabilities and funding. In order to prepare for next year, we would like to know which language offerings interest you most. Nursery and Preschool students can choose between English, Polish and English as Another Language (three times per week). Students in grade 0 to 12 choose a Native Language class that meets five times per week and a Foreign Language class that meets three times per week.

Please rank in order of importance 1= Most important, 2= Second most important, 3= Third most important

NATIVE LANGUAGE

FOREIGN LANGUAGE

ENGLISH AS AN ADDITIONAL LANGUAGE (EAL)

 Polish

 Polish

 French

 French

 German

 German

 Dutch *

 Spanish

*If separately enrolled in the Dutch School operating within ISK after school hours

 E.A.L

_________________________________________ Parent/Guardian’s Signature

Date

ISK Admission Packet - 9 -


The International School of Kraków

Lusina ul. Św. Floriana 57, Kraków 30-698 Tel/ Fax: +48 12 270 14 09 E-mail: school@iskonline.org On the Web: www.iskonline.org

APPROVED MODES OF TRANSPORT TO AND FROM SCHOOL

Student’s name ______________________

Grade _____________

(Check all that apply)

  

My child may choose to use public transportation/on foot My child may choose to call a taxi for pick-up My child may leave school with any other parent from the school

Parent(s)/Guardians named ________________________________may take my child from school.

If you choose another person or approved method of transport, please notify the school in a signed letter. We will assume that a child’s parents/guardians are authorized to pick them up, unless we are informed otherwise.

_________________________________________ Parent/Guardian’s Signature

Date

ISK Admission Packet - 10 -


The International School of Kraków

Lusina ul. Św. Floriana 57, Kraków 30-698 Tel/ Fax: +48 12 270 14 09 E-mail: school@iskonline.org On the Web: www.iskonline.org

PHYSICAL EDUCATION QESTIONNAIRE Student’s name ________________________

Grade _____________

To make sure your child can benefit from safe and active Physical Education classes, please provide specific information regarding your child’s health condition.

(Please tick appropriate)

 My child may participate in all physical activities.  Performance in PE classes may be affected by the following: A. Physical problem (allergies, asthma, etc.). Please explain. _____________________________________________________________________________ _____________________________________________________________________________ B. Special medication which may affect performance. Please explain. _____________________________________________________________________________ _____________________________________________________________________________

_________________________________________ Parent/Guardian’s Signature

Date

ISK Admission Packet - 11 -


The International School of Kraków

Lusina ul. Św. Floriana 57, Kraków 30-698 Tel/ Fax: +48 12 270 14 09 E-mail: school@iskonline.org On the Web: www.iskonline.org

CONTRACT FOR ACADEMIC YEAR _______ - ________

Child’s Name (LAST, first, middle) ____________________ Grade ____ Date ______________ This contractual agreement is being entered into by the Board of Trustees of the International School of Krakow, as represented by the Director of ISK and _________________________________ Parent’s/ Guardian’s name

Services rendered by the school for the aforementioned child(ren) are for an appropriate English language grade level instruction each day Monday – Friday for the Academic Year _______ _______, excepting school-designated holidays and emergency school closures. In consideration of these services, the parent(s)/ guardian(s) shall provide the following to the school: 1. Pertinent school records for placement and review prior to full acceptance. This shall be waived if the child(ren) has/have already been enrolled. 2. Medical records indicating appropriate vaccinations, inoculations and physical examinations have been performed and found the child to be in good health. 3. Emergency information in case of need for immediate contact. 4. Signed forms: As included in the current Admissions Packet 5. Payment of agreed upon fees.

ISK Admission Packet - 12 -


The International School of Kraków

Lusina ul. Św. Floriana 57, Kraków 30-698 Tel/ Fax: +48 12 270 14 09 E-mail: school@iskonline.org On the Web: www.iskonline.org

TUITION AND FEE SCHEDULE: 2011-2012 All amounts in this document are in Euros. The School’s Fiscal Year is 1 July to 30 June. One time only: Application – Nursery + Preschool EUR 200, 0-12 EUR 500 (non-refundable) Annual Tuition:

Nursery – EUR 5,145 Pre School – EUR 8,085 Grade 0 – Grade 12 – EUR 12,180

Name (Last, First, Middle): _______________________________________________________ Address: ______________________________________________________________________ Zip-Code: _______________ Country: ____________________ Please mail the invoice to: ________________________________________________________ _____________________________________________________________________________ The name of the contact person is: ______________________________ Telephone number: _______________________

Important Note: Due to the school’s financial obligations, the preferred method of payment is one single annual payment. In cases of need, parents may choose from one of three payment options for the tuition fees (annual or bi-annual or 9 monthly payments with 5% service charge). It is however, understood and agreed that the actual payment is based upon the full School Fiscal Year running July 1 st 2011– June 30th 2012. Options for payment plans are merely a convenience set up for the parents/guardians. Please understand that the school depends upon the prompt payment of school fees in order to meet its own obligations in a timely manner. All tuition payments to the school must be paid in advance of services provided rather than after. Your understanding and cooperation are greatly appreciated.

ISK Admission Packet - 13 -


The International School of Kraków

Lusina ul. Św. Floriana 57, Kraków 30-698 Tel/ Fax: +48 12 270 14 09 E-mail: school@iskonline.org On the Web: www.iskonline.org

TUITION INSTALLMENT OPTIONS: The application fee (for new students) is due on or before August 1st I. Annual: II. Bi-Annual:

One installment paid on or before:

August 1st

Two installments paid on or before: August 1st, January 1st

III. Monthly. Nine installments paid begin August 1st to April 1st with a 5% service charge. The total fees for _____________ for Academic Year _______ - ______ are _________________ Currency for Payment:

 EURO

 PLN

 USD

It should be noted that tuition and fees are quoted in Euro. Therefore, if a currency is exchanged, it will be converted into Euro based on the July 1 st exchange rate of the contracted year.

Payment Schedule:

 Annual

 Bi-Annual

 Monthly with a 5% service charge

If a student withdraws during the school, the school will refund 50% of the tuition for any quarters not attended: If before end of Q1 – 37,5% of annual tuition If before end of Q2 – 25% of annual tuition If before end of Q3 – 12,5% of annual tuition

Non-payment penalty: Any account 30 days overdue will be considered in non-payment and subject to a 300 Euro non-payment Penalty. Furthermore, any parent/guardian whose account falls into arrears by 60 days may have school attendance privileges withdrawn from their child(ren). No records may be forwarded to other schools or given to parents until payment is made in full. I/We have read, understood and agreed to this contract. I/We understand that I/We, the parent(s)/ guardian(s) are ultimately responsible for the financial obligations of this contract.

________________________________ Parent/Guardian signature Date

_________________________________ Director’s signature Date

ISK Admission Packet - 14 -

/Admission_Packet_2011-2012  

http://www.iskonline.org/files/forms/Admission_Packet_2011-2012.pdf

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