Wye River Upper School

316 S. Commerce St., Centreville, MD 21617

katietheeke@wyeriverupperschool.org

Application for Admission

Please use the following checklist.

Fill out the Applicant Information page and return to Wye River Upper School with a $75
application fee made payable to the Wye River Upper School. Or contact Administrative
Assistant Kara Frison to pay by credit card over the phone – 410-758-2922.

Complete the Parent Form and Student Form.

Arrange testing and/or send in current testing. Testing is considered complete if it includes
a test of cognition (i.e. WISC, Woodcock Johnson), and achievement (i.e. Woodcock Johnson,
WIAT). If student has other testing such as behavioral or psychological, those documents
should also be submitted. Contact Admissions Office if testing is more than 3 years old or if
the student has never had testing.

Deliver the Transcript Release Request and Teacher Recommendation Forms to

appropriate personnel at student’s current school.

Provide a current photo.

Contact Admissions Office to schedule a shadow day for your student.

Please note:

If the number of qualified applicants exceeds the number of spaces available, the
committee will consider date of application as one of the determining criteria.
The admissions committee will process complete applications only. Falsifications on
applications are reason for dismissal.
Wye River Upper School encourages applications from and admits students of any racial,
ethnic or religious background. Its programs and policies are applied with equal consideration to
all of its applicants and students.

Wye River Upper School | 316 S. Commerce St. | Centreville | MD | 21617 ph: 410.758.2922 fax: 410.758.2919
 Wye River Upper School
316 S. Commerce St., Centreville, MD 21617
katietheeke@wyeriverupperschool.org

Applicant’s full name Nickname

male female Birth date Social Security Number

Applying for entry to Wye River Upper School for September for grade
(Year)
Do you intend to apply for financial aid? Yes No

Present School Information

School Name Grade

Address

Principal/Head School Phone

List all other schools attended (please also provide dates)

Family Information

Full name of father or guardian

Home Address

City State Zip

Home Telephone Email Address

Occupation Name of Employer

Business Address Business Telephone

Full name of mother or guardian

Home Address

City State Zip

Home Telephone Email Address

Occupation Name of Employer

Business Address Business Telephone

Please check if  divorced  separated who has legal custody:

If applicant is not living with both parents, pleased indicate with whom the child resides.

Correspondence regarding application should be sent to:

Wye River Upper School | 316 S. Commerce St. | Centreville | MD | 21617 ph: 410.758.2922 fax: 410.758.2919
 Wye River Upper School
316 S. Commerce St., Centreville, MD 21617
katietheeke@wyeriverupperschool.org

Application for Admission - Parent Questionnaire and Response

(Please feel free to attach additional pages, if necessary.)

Name of Student: Entry grade:

What would you hope WRUS can provide for your student?

What are his/her strengths, talents, interests?

Weaknesses?

Do you have concerns about this student’s social, emotional, or behavioral functioning? Has this
been a challenge for him/her in any setting? If so, please explain.

Wye River Upper School | 316 S. Commerce St. | Centreville | MD | 21617 ph: 410.758.2922 fax: 410.758.2919
Has your student ever been in school suspended? Yes  No  If yes, please explain.

Has your student ever been out-of-school suspended? Yes  No  If yes, please explain.

Do you now or have you ever had any suspicions/knowledge of alcohol, tobacco, or drug use? If
yes, what actions are taking in response?

Has your student ever been referred for or received legal consequences or treatment for alcohol,
tobacco, or drug use?

Describe the level to which you believe in the value of structure and consistent enforcement of
all rules. What part do you feel parents play in supporting that structure and enforcement?
Please use the back of this sheet. We thank you for your thoughtful and truthful response.