Harmony School Online Application
High School Students
9th, 10th & 11th Grade Only

Please fill out the following form and then click the "submit" button at the bottom of the page. In our efforts to be in touch with you, we may ask for more information. Please give us the most reliable contact information you possibly can. Thank you very much for your interest in Harmony School.

This application will be added to our wait list. Generally, interviews take place in late spring and early summer. If there is an opening in the applicant’s grade, you will be called for an interview.

All fields require an entry to submit the form. If a field does not apply or you do not have the information, please enter, "n/a" or some other character to let us know that you have reviewed that question.

Please enter your email address (valid email required):
Student's name:
Date of Birth:
Place of Birth:
Gender	Male Female
Parent #1
Home Address
City
State
Zip Code
Home Phone
Email Address
Workplace
Occupation
Work Phone
Cell Phone
Hobbies/Interests
Parent #2
Home Address
City
State
Zip Code
Home Phone
Email Address
Workplace
Occupation
Work Phone
Cell Phone
Hobbies/Interests
Names and ages of student's siblings:
Applicant's current school?
What grade will the applicant be entering in the upcoming school year? Due to our specialized program for Seniors, the 11th Grade is the last grade we accept students.
Do you know anyone associated with Harmony School?	Yes No
If so, who do you know?
Why does the student want to attend Harmony?
What special interests or abilities does the student have that the student could share with the community?
Harmony School has a Parental Involvement Program (PIP). Families are required to complete 45 hours of volunteer work for the School. What skills could the parents share with the community?
Other Comments
In order to provide scholarships, our fee structure is based on a sliding scale. We ask that families of students in grades 1 to 12 pay 8% of adjusted gross income for one child up to $475 per month, 12 months a year. How much could the student's family pay per month?

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Harmony Education Center
909 East 2nd Street, Bloomington, IN 47401
ph: 812/334.8349   fax: 812/333.3435
Comments? webmaster@harmonyschool.org
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