This is the North Fork School Online Application Form for the Second Year Program in American Literature and History. Fill out the application, print a copy for your records, then send a print copy to The North Fork School at:

The information provided on this form will not be shared with any individual, organization, or business outside of The North Fork School. It will be kept with each student's records in a secure place, and will be used only for the purposes of communicating with each student's family.

Name:

Grade in Sept. 2009:

Birthdate:

2009 State Writing Assessment score:

E-mail Address:

Street or PO Box address:

City, State, Zip:

Phone:

Mother's Name:

Mother's E-mail Address:

Street or PO Box address:

City, State, Zip:

Work Phone:
Cell Phone:

Father's Name:

Father's E-mail Address:

Street or PO Box address:

City, State, Zip:

Work Phone:
Cell Phone:

Why do you want to enter the North Fork School Program?:

What are your interests/hobbies/sports/favorite classes?:

What are your goals for this course?:

List three words that describe your physical presence:

List three words that describe your unique emotions:

List three words that describe your intellectual traits:

List three words that describe your spirit:

Create a piece about yourself using the traits you listed above. It can be a poem, or a paragraph, or a letter, or any other written form that appeals to you. Make it as specific and as polished as you can:

After your piece is finished, write a second version of the same piece that reveals how you hope to be different at the end of the program next Spring: