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Applicant' Name: Age: Date of Birth:
Present School: Present Grade:
Primary Language: Secondary Language:
 
 
Parent Name:
Mailing Address:
City: State: Zip:
Home Phone:
Cell Phone:
Occupation:
Business Phone:
Email:
Parent Name:
Mailing Address:
City: State: Zip:
Home Phone:
Cell Phone:
Occupation:
Business Phone:
Email:

 
Please Attach a Family Picture:
 
Other Guardian or Legally Responsible Person:
Name: Home Phone:
Mailing Address: Cell Phone:
City: State: Zip: Relationship:

 
 

Part I:
Using the available space below, use only a word or two to provide some information to create “talking points” during the interview. We do not seek written out answers to these questions, merely a brief title so we can ask your child, and/or you about it during the interview.

1. An incident that demonstrates your child’s resiliency:
2. A project that you feel your child self-initiated:
3. An example of your child’s willingness to risk:
4. An illustration of your child’s emotional strength:
 
 
Part II
List five adjectives that describe your child:
Part III
List all of your child’s extracurricular activities:
Part IV
What single word do you feel best describes Odyssey School?
Part V
Please briefly answer the general questions below. Please use as much space as you would like.
1. How did you hear of Odyssey School?
2. Which students, parents, or staff of Odyssey do you know?
3. Has your child ever been tested for academic, medical or psychological concerns?
Part VI
Please answer the below questions in short answer form. Please use as much space as you would like.
1. Describe the manner in which your child learns most effectively:
2. Describe your child’s interactions with peers:
3. Explain why you are seeking application to Odyssey School:
Part VII
Please list the other schools to which your child will be applying and the name of your neighborhood middle school.
 
 

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Odyssey School, 201 Polhemus Road, San Mateo, CA 94402
(650) 548-1500