American School of Doha
P.O. Box 22090, Doha, Qatar
Tel: +974 4459-1500 Fax: +974 4459-1570
Email: info@asd.edu.qa
High School Tel: +974 4499-1100
Middle School Tel: +974 4499-1200
Elementary School Tel: +974 4459-1550
Elementary School: Tel: (974) 459-1524
Dr. Deborah Welch
Director
Colin Boudreau
High School Principal
…Where education meets the future
Steven Leever
Middle School Principal
Brian Donaldson
Upper Elementary Principal
Lana Al-Aghbar
Lower Elementary Principal
Dear Parents, On behalf of our Director, Dr. Deborah Welch, welcome to the American School of Doha! We appreciate your interest in our school. Established in 1988, the American School of Doha is an independent, U.S. accredited, college preparatory school, committed to providing educational excellence, through a standards-­‐based, internationally enriched American curriculum, serving a multicultural student body. Today, with over 2060 students, representing more than 67 countries, the American School of Doha is recognized as one of the leading, non-­‐profit international schools in the world. We are proud of the legacy we have built, and pleased that you are considering becoming part of our community of learners. Enclosed in our view book, you will find information that will provide you with a glimpse of our involved administrators, talented faculty, students, and spectacular campus. We also encourage you to fully explore our website at http://www.asd.edu.qa. You will view detailed information regarding our ASD community, curriculum, course descriptions, and activities. As a teacher, administrator, and parent of two, I can honestly say that I am excited that my children attend this school. ASD is a learning focused school; it is a school where the feel of community is real, and where children learn and develop in a safe, nurturing, creative atmosphere, in the presence of very dedicated educators who teach in a professional manner. Your inquiry regarding admission to ASD is important to us. We understand the importance of your decision, when it comes to finding the right school for your children. We want the admissions process to be clear and our communication to be welcoming, helpful, and responsive. Should you be visiting Doha or arriving soon, we encourage you to contact us via email at admissions@asd.edu.qa or phone at +974 4459 1511 in order to make arrangements for a school tour. Due to scheduling and security purposes, we do encourage an arranged appointment prior to your visit. We look forward to meeting you and assisting your family, as you become a part of the legacy that is ASD! Warm regards, Scott Barnwell Director of Admissions American School of Doha Doha, Qatar http://www.asd.edu.qa ASD Identity Statement
The American School of Doha is an independent, U.S. accredited, college preparatory school, committed to providing
educational excellence, through a standards based, internationally enriched American curriculum, serving a multicultural
student body.
ASD Mission
The American School of Doha is committed to the intellectual and personal development of our students, inspiring and
empowering them to become positive, active global citizens.
Accredited by the New England Association of Schools and Colleges, Inc.
ADMISSIONS DOCUMENTATION REQUIREMENTS
o
o
o
o
o
o
o
o
Admission Application
Application Fee (non-refundable/non-transferrable)
School Records (as specified below)
School Fees/Policies (signature required)
Student School History Form
Parent Questionnaire
Copy of Passport or Birth Certificate
Recent Passport Size Photo
o
o
o
o
o
o
o
o
o
MS/HS Counselor Recommendation Form (6-12)
MS/HS Math Recommendation Form (6-12)
MS/HS English Recommendation Form (6-12)
Upper Elementary Recommendation Form (3-5)
Lower Elementary Recommendation Form (PK - 2nd)
Health Questionnaire
Health Examination Form
Immunization Record (English translation required)
Letter from Employer
SCHOOL RECORDS:
o
o
o
Elementary School Applicants: provide last 3 years of school reports, in English.
Middle School Applicants: provide last 3 years of school reports, in English.
High School Applicants: provide official transcript, a school profile, and last 3 years of school reports,
in English. **Please note, that once the student is accepted, parents/students are responsible for
providing all FINAL reports and official sealed transcripts to the school.
o We request any additional information that may assist us in the evaluation process:
o Narrative reports
o Summaries
o Program modifications of students, such as:
§ Psychological / Educational Evaluations
§ Academic Program Accommodations (504 plans)
§ Behavior Modification Programs
§ Individualized Educational Programs (IEPs)
SPECIFICATIONS:
o All records & documents must be submitted in English. Translated/certified copies of records must show an
official stamp from the translator. The student’s parents may not translate records.
STANDARDIZED TEST SCORES:
Most American schools in the USA and abroad administer one of the following norm-referenced tests. If you have any
standardized tests that were administered to your child(ren), please provide us with the most recent report.
Some examples include:
•
•
•
•
Iowa Test of Basic Skills (ITBS)
Stanford Achievement Test
California Achievement Test (CAT)
Test of Achievement and Proficiency (TAP)
•
•
•
•
State/Provincial Standardized Tests (USA & Canada)
Measure of Academic Progress (MAP)
PSAT (if taken)
SAT
ADDMISSION ASSESSMENT:
o
o
Even with the above documentation, an on site admissions assessment will be required for all applicants.
Assessments take place throughout the year as seats become available, and/or during the spring of each school
year.
The initial admission assessment does not guarantee a seat to be held. Seats will be offered based on Board
policy priority and seat availability once a student qualifies.
If you submit an application via email to admissions@asd.edu.qa, we will do our best to confirm receipt within 24 hours (*not
possible during the busy season of March-May).
** The American School of Doha reserves the right to contact schools previously attended in order to validate records provided and/or
inquire about the student(s) in question.
THE AMERICAN SCHOOL OF DOHA
ASD Identity Statement
The American School of Doha is an independent, U.S. accredited, college
preparatory school, committed to providing educational excellence, through
a standards based, internationally enriched American curriculum, serving a
multicultural student body.
ASD Mission
The American School of Doha is committed to the intellectual and personal
development of our students, inspiring and empowering them to become
positive, active global citizens.
ASD Vision
ASD is a vibrant learning community...
where learning is fun
where learning is creative
where learning is authentic
where learning is innovative
where learning is collaborative
where learning is data-informed
where learning is technology infused.
ASD is where learning extends beyond walls...
ASD Values
Respect
Honesty
Responsibility
Compassion
SCHOOL FEES/POLICIES
2012/2013
Please find outlined below our payment structure. If you should have further questions, please contact our
Business Office at +974 4459-1520.
** Please note that the new Fees and Policies for the 2013-2014 academic year will be approved and published
after the Board of Directors meeting in March 2013. The Fees and Policies listed below are for the 2012-2013
school year only.
APPLICATION FEE:
Ø
The application fee of QR 500 is non-refundable and non-transferable and payable upon submission of
application materials for new students.
Ø This fee is separate from the capital, registration and tuition fees.
An application fee of QR 500 must be paid when submitting an application. This fee covers the cost of processing and
reviewing the application. Please note that the school does not corporate bill for this fee. There are 3 ways to pay this
fee that are outlined below. *Please note that ASD will only process applications that have paid application fees.
1.
QR 500 cash
2.
QR 500 check, made payable to the American School of Doha
3.
Electronic Transfer of Funds, which can be sent in USD at $137.00 per application. Once
completed, a copy of the bank receipt must be sent to verify that the payment has been made.
Bank Details:
• Bank Name: BNP
• Bank Address: Doha - Qatar
• Benf. Name: American School of Doha
• A/C: 073742-001-61
• Swift Code: BNPAQAQA
REGISTRATION FEE:
Ø
This fee is a one-time registration fee of QR 3,650 that is non-transferable and non-refundable for each child.
CAPITAL FEE:
Ø
This non-refundable fee is for ASD’s loan repayment on our current facilities, payable in the semester invoice.
o Pre-Kindergarten: QR 5,475 (Yearly Cost: QR 10,950)
o Kindergarten to Grade 12: QR 7,300 (Yearly Cost: 14,600)
TUITION FEE:
Grade
Pre-Kindergarten
Kindergarten
Grade 1-5
Grade 6-8
Grade 9-12
Ø
Ø
Ø
Ø
Ø
Ø
Cost/Semester
QR 15,490
QR 25,830
QR 25,830
QR 33,590
QR 33,590
Cost/Year
QR 30,980
QR 51,660
QR 51,660
QR 67,180
QR 67,180
Parents are responsible for prompt payment of all school fees.
All tuition and fee payments are due and payable prior to the start of each academic semester.
The tuition fee is billed on a yearly basis for those students sponsored by a company. Individuals are billed on a
semester basis.
As according to Board policy, if payments are not made within two weeks of the due date, the student(s) will not
be permitted to attend class.
A full term tuition fee will be assessed for the semester during which enrollment occurs, regardless of when it
occurs within the semester.
Should a student withdraw, tuition fees will be reimbursed on a quarter basis. Refunds are not granted to
students of corporations or organizations; rather the tuition may be transferred to a new incoming student
provided the new student attends ASD within the same school year.
RE-ENROLLMENT DEPOSIT:
Ø A deposit of QR 5,000 for the first child and an additional QR 1500 for each child thereafter, is due at reenrollment time to secure a seat for your child for the next academic year. This will be deducted from your
tuition fee.
SENIOR FEES:
Ø A fee of QR 365 will be assessed for graduating seniors.
I hereby acknowledge receipt of a copy of the American School of Doha's publication on School Fees and
Admission Policies. (Please retain a copy for your records)
Parent Signature: ________________________________________ Date: ________________________
ASD Grade Levels - 2013/2014 Age
Date of Birth
USA
4
Sept. 1, 2008 - Aug. 31, 2009
Pre-Kindergarten
Sept. 1, 2007 - Aug. 31, 2008
Kindergarten
Year 1/1st year infants
Sept. 1, 2006 – Aug. 31, 2007
Grade 1
Year 2 / 2nd year infants
Sept. 1, 2005 – Aug. 31, 2006
Grade 2
Year 3 / Junior 1
Sept. 1, 2004 - Aug. 31, 2005
Grade 3
Year 4 / J2
Sept. 1, 2003 – Aug. 31, 2004
Grade 4
Year 5 / J3
Sept. 1, 2002 – Aug. 31, 2003
Grade 5
Year 6 / J4
Sept. 1, 2001 – Aug. 31, 2002
Grade 6
Year 7 / Secondary 1
Sept. 1, 2000 – Aug. 31, 2001
Grade 7
Year 8 / Secondary 2
Sept. 1, 1999 - Aug. 31, 2000
Grade 8
Year 9 / Secondary 3
Sept. 1, 1998 – Aug. 31, 1999
Grade 9
Year 10 / Secondary 4
Sept. 1, 1997 – Aug. 31, 1998
Grade 10
Year 11/ Secondary 5
Sept. 1, 1996 – Aug, 31, 1997
Grade 11
Year 12 / Secondary 6
Sept. 1, 1995 – Aug. 31, 1996
Grade 12
Year 13 / Secondary 7
5
6
7
8
9
10
11
12
13
14
15
16
17
UK/Australian
Application for Admission
AMERICAN SCHOOL OF DOHA
P.O. Box 22090
Doha, Qatar
Proposed Start Date: _________________________
Student
Photo
Here
Grade Applying For: _________________________
Date Arriving to Doha: _______________________
Current School: _____________________________
Candidate’s First Name
Date of Birth
mm/
dd/
Middle Name
Gender
Family Name
Language at Home
Passport Country
Other Language
yy/
Child’s Residency/ID Number
Full Name of Siblings
Last
Father’s Full
Name
Father’s
Please Mark One
At ASD
Applying
Age
First
Middle
Work
Phone
Residency/ID
Number
Mother’s Full
Name
Mother’s
Last
First
Middle
Work
Phone
Residency/ID
Number
Mobile (mom)
Mobile (dad)
Primary Email
Home Phone
Does your employer pay tuition directly to
the school?
Is the tuition paid directly to you?
Yes ( ) No ( )
Last
First
Name of Employer:
Yes ( ) No ( )
Please include our family in the ASD PTA Directory:
Do you have a family member who is an Alumni of ASD?
If
“yes”
Grade
Email:
YES ( )
YES ( )
NO ( )
NO ( )
Dates Attended:
What or who had the most influence on your choice of school? (please select below)
( ) Company Referral ( ) Parent Network ( ) Friends
( ) Website
( ) Other
ASD does not discriminate on the basis of race, color, religion, or national or ethnic origin in its admission policy and administration
of its school programs.
Updated July. 2012
STUDENT HISTORY FORM
PLEASE COMPLETE THE REQUESTED FIELDS. IT IS IMPORTANT TO PROVIDE US WITH THE DATES THE STUDENT ATTENDED EACH SCHOOL NAME OF STUDENT: GRADE NURSERY
PRE-K
KINDERGARTEN
GRADE 1
GRADE 2
GRADE 3
GRADE 4
GRADE 5
GRADE 6
GRADE 7
GRADE 8
GRADE 9
GRADE 10
GRADE 11
GRADE 12
ADDRESS NAME OF SCHOOL City, State , Country Is your child currently eligible to return to their current school?  Yes REASON FOR LEAVING DATES ATTENDED (Month/Year)  No Parent Signature: __________________________________________________ American School of Doha
PRINCIPAL or COUNSELOR RECOMMENDATION
Grades Six through Twelve
Name of Applicant: ________________________________________
Grade Applying: _______
Parent or Guardian
Parent or Guardian: Please write your child’s name in the space above and read and sign the following before giving
this to your child’s counselor or principal.
I understand and agree that the information contained on this recommendation form is confidential and will be used only in
the selection of applicants. It will not become part of the applicant’s permanent file. I also understand that this completed
form will not be available to applicants, parents, or anyone outside the Admissions Committee, and I waive any right that I
may have to see it.
_______________________________________
______________________________
Signature of Parent or Guardian
Date
Teacher
Teacher: Please complete this form and return it in the enclosed envelope, by e-mail.
This Teacher Recommendation form will be treated confidentially and will not be shared with parents. Thank you for your
cooperation and honesty.
The child’s application cannot be processed until this form is received in our Office of Admissions.
Please complete for candidates
for grades 6 - 12
Excellent
(Top 10%)
Good
Average
Below
No Basis
Average
for
Judgment
Ability to get along with other students
Politeness
Self-discipline
Maturity
Respect from peers
Study habits and organizational ability
Energy
Perseverance under pressure
Leadership
Self-confidence
Warmth of personality
Sense of humor
Concern for others
Reaction to criticism
1.
Describe any particular area of academic strength or weakness: __________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
2.
Does the candidate have any learning needs requiring special support? Please be
specific. _____________________________________________________________
____________________________________________________________________
____________________________________________________________________
1
3.
Has the candidate, in any way, been a disciplinary problem? If so, please explain. ___
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
4.
What interest do the candidate’s parents show in his-/her activities and studies? _____
_____________________________________________________________________
_____________________________________________________________________
5.
What is the candidate’s approximate rank in class to the nearest tenth? (i.e. 20%
means that 80% of his classmates fall BELOW the candidate in academic
performance) _________________________________________________________
What is the approximate percent of the class that will attend college? _____________
Should the candidate be in a college-preparatory program? _____________________
6. Summary Statement – Please write a summary statement assessing in as specific
terms as possible the candidate’s quality and promise as a student and person. We are
particularly interested in evidence about character, relative maturity, values, and
special interests or talents. If the candidate’s record is not a true indication of his/her
ability, please explain factors that have contributed to his/her academic achievement.
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
7. I recommend this candidate for The American School of Doha:
Please
Complete
Character
Not
Recommended
Without
Enthusiasm
Fairly
Strongly
Strongly
Enthusiastically
Academic
Ability
Date _____/_____/_____
day / month /
Signature: _________________________________
year
Counselor Email: ___________________________
Please mail, or e-mail this form directly from the school to:
Director of Admissions
The American School of Doha
P. O. Box 22090 Doha, Qatar
Phone: +(974) 4459-1511
Email: admissions@asd.edu.qa
2
American School of Doha
MATH TEACHER RECOMMENDATION
Grades Six Through Twelve
Name of Applicant: __________________________________
Parent or Guardian
Grade Applying: _______
Parent or Guardian: Please write your child’s name in the space above and read and sign the following before
giving this to your child’s teacher.
I understand and agree that the information contained on this Teacher Recommendation form is confidential and will be
used only in the selection of applicants. It will not become part of the applicant’s permanent file. I also understand that
this completed form will not be available to applicants, parents, or anyone outside the Admissions Committee, and I
waive any right that I may have to see it.
___________________________________________________
______________________________
Signature of Parent or Guardian
Date
Teacher
Teacher: Please complete this form and return it in the enclosed envelope, by e-mail.
This Teacher Recommendation form will be treated confidentially and will not be shared with parents. Thank you for
your cooperation and honesty.
The child’s application cannot be processed until this form is received in our Office of Admissions.
Academic Skills
Ratings
Listens to and follows teacher’s directions
Is attentive to group discussions/activities
Contributes appropriately to group discussions/activities
Demonstrates ability to work independently
Perseveres in spite of difficulty
Works cooperatively
Enjoys new challenges
Demonstrates appropriate energy level
Demonstrates ability to stay on task
Exhibits appropriate work ethic
Truly
Outstanding
Excellent
Above
Average
Average
Below
Average
Comments on any of the above skills:______________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Social Skills
Ratings
Responds positively to constructive criticism
Establishes friendships easily
Is comfortable in a group
Is respectful to faculty
Is respected by peers
Demonstrates self-control
Takes responsibility for belongings
Is cooperative
Demonstrates appropriate behavior
Exhibits emotional maturity
Demonstrates appropriate energy level
Takes pride in appearance
Truly
Outstanding
Excellent
Above
Average
Average
Below
Average
Comments on any of the above skills:_______________________________________________________
_____________________________________________________________________________________
Name of Applicant: _________________________________________
Grade Applying: _______
Mathematical Ability
Ratings
Truly
Outstanding
Excellent
Above
Average
Average
Below
Average
Computational Skills
Problem-solving skills
Mathematical reasoning
Mathematical applications
Which math course did you teach this student this year? __________________________
FILL IN FOR HIGH SCHOOL STUDENTS ONLY:
Which math course is the student best prepared to enter?
Basic Algebra ___, Algebra (a thorough course which includes linear and quadratic functions) ___,
Geometry (a thorough course which includes proofs) ___, Algebra II (including functions and trigonometry) ___,
Pre-Calculus (including analytical trigonometry) ___, Calculus ___, Advanced Placement Calculus AB ____
•Briefly describe the work habits/abilities/challenges. __________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
•Is applicant habitually tardy or absent? ___________
If yes, please explain. __________________________________________________________________________________
____________________________________________________________________________________________________
•This applicant is: ___Highly Recommended (Top 5%) ___Strongly Recommended ___Recommended
___Recommended with Reservations ___Not Recommended
If you checked “Recommended with Reservation” or “Not Recommended”, please explain. If the same recommendation is
not appropriate for all the schools to which the applicant is applying, please explain. ________________________________
_________________________________________________________________________________________________
•Is there anything regarding the applicant that would be helpful for the Admissions Committee to know? _________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
• Is there anything regarding the family that would be helpful for the Admissions Committee to know? __________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
• I would: ___like to ___be willing to discuss this applicant by telephone.
Signature of Teacher: __________________________
Date: _____________________________
Print Name: _________________________________
Name of School: ______________________________
Telephone: ________________________
School Address: ___________________________________________________________________
Please mail, or e-mail this form directly from the school to:
Director of Admissions
The American School of Doha
P. O. Box 22090 Doha, Qatar
Phone: +(974) 4459-1511
Email: admissions@asd.edu.qa
American School of Doha
ENGLISH TEACHER RECOMMENDATION
Grades Six Through Twelve
Name of Applicant: ________________________________________
Parent or Guardian
Grade Applying: _______
Parent or Guardian: Please write your child’s name in the space above and read and sign the following before
giving this to your child’s teacher.
I understand and agree that the information contained on this Teacher Recommendation form is confidential and will be
used only in the selection of applicants. It will not become part of the applicant’s permanent file. I also understand that
this completed form will not be available to applicants, parents, or anyone outside the Admissions Committee, and I
waive any right that I may have to see it.
_______________________________________
______________________________
Signature of Parent or Guardian
Date
Teacher
Teacher: Please complete this form and return it in the enclosed envelope, by e-mail.
This Teacher Recommendation form will be treated confidentially and will not be shared with parents. Thank you for
your cooperation and honesty.
The child’s application cannot be processed until this form is received in our Office of Admissions.
Academic Skills
Ratings
Listens to and follows teacher’s directions
Is attentive to group discussions/activities
Contributes appropriately to group discussions/activities
Demonstrates ability to work independently
Perseveres in spite of difficulty
Works cooperatively
Enjoys new challenges
Demonstrates appropriate energy level
Demonstrates ability to stay on task
Exhibits appropriate work ethic
Truly
Outstanding
Excellent
Above
Average
Average
Below
Average
Comments on any of the above skills: _____________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Social Skills
Ratings
Responds positively to constructive criticism
Establishes friendships easily
Is comfortable in a group
Is respectful to faculty
Is respected by peers
Demonstrates Self-control
Takes responsibility for belongings
Is cooperative
Demonstrates appropriate behavior
Exhibits emotional maturity
Demonstrates appropriate energy level
Takes pride in appearance
Truly
Outstanding
Excellent
Above
Average
Average
Below
Average
Comments on any of the above skills: _____________________________________________________
____________________________________________________________________________________
Name of Applicant: _________________________________________
Grade Applying: _______
Communication Skills
Ratings
Ability to express ideas verbally
Clarity of writing style
Grammar/Mechanic skills
Reading rate and fluency
Reading comprehension
Knowledge and usage of vocabulary
Imagination and creativity
Truly
Outstanding
Excellent
Above
Average
Average
Below
Average
Comments on any of the above skills: _____________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Circle the words that best describe this applicant.
Aggressive
Anxious
Articulate
Cheerful
Confident
Conscientious
Disobedient
Easily discouraged
Follower
Helpful
Honest
Immature
Irritable
Manipulative
Mature
Motivated
Negative leader
Oppositional
Organized
Over-protected
Perfectionist
Positive leader
Responsible
Self-centered
Self-disciplined
Shy
Social
Vivacious
Well-liked
Witty
•Briefly describe the work habits/abilities/challenges. __________________________________________________________
____________________________________________________________________________________________________
•Is applicant habitually tardy or absent? ___________
If yes, please explain. __________________________________________________________________________________
•This applicant is: ___Highly Recommended (Top 5%) ___Strongly Recommended ___Recommended
___Recommended with Reservations ___Not Recommended
If you checked “Recommended with Reservation” or “Not Recommended”, please explain. If the same recommendation is
not appropriate for all the schools to which the applicant is applying, please explain. ________________________________
_________________________________________________________________________________________________
•Is there anything regarding the applicant that would be helpful for the Admissions Committee to know? _________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
• Is there anything regarding the family that would be helpful for the Admissions Committee to know? __________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
• I would: ___like to ___be willing to discuss this applicant by telephone.
Signature of Teacher: __________________________
Date: _____________________________
Print Name: _________________________________
Name of School: ______________________________
Telephone: ________________________
School Address: ___________________________________________________________________
Please mail, or e-mail this form directly from the school to:
Director of Admissions
The American School of Doha
P. O. Box 22090 Doha, Qatar
Phone: +(974) 4459-1511
Email: admissions@asd.edu.qa
PRINCIPAL/COUNSELOR/TEACHER RECOMMENDATION
Grades Three through Five
Name of Applicant: ________________________________________
Applying for Grade: _______
Parent or Guardian
Parent or Guardian: Please write your child’s name in the space above, read and sign the following before giving
this form to the reference for your child.
I understand and agree that the information contained on this recommendation form is confidential and will be used only
in the selection of applicants and will not become part of the applicant’s permanent file. I also understand that this
completed form will not be available to applicants, parents, or anyone outside the Admissions Committee, and I waive
any right that I may have to see it.
_______________________________________
______________________________
Signature of Parent or Guardian
Date
Counselor, Principal, or Teacher
Please complete this form and return it in an envelope, or email it to the Office of Admission listed below.
This Counselor/Principal/Teacher Recommendation Form will be treated confidentially and will not be shared with
parents. Thank you for your cooperation and honesty.
The child’s application cannot be processed until this form is received in our Office of Admissions.
How long have you known this student? ______________
Please complete for grade 3-5
candidates
Ability to get along with other students
Politeness
Self-discipline
Maturity
Personal appearance
Study habits and organizational ability
Ability to focus
Perseverance
Leadership
Self-confidence
Ability to work independently
Sense of humor
Concern for others
Ability to utilize feedback/criticism
Excellent
(top 10%)
Good
Average
Below
Average
No Basis for
Judgment
1. Describe any particular area of academic strength and weakness.
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
1
2. Does the candidate have any learning needs requiring special support? Please be specific.
________________________________________________________________________
________________________________________________________________________
_______________________________________________________________________
3. Has the candidate, in any way, been a disciplinary problem? If so, please explain.
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
4. What is the interest level of the candidate’s parents in his/her learning and/or activities?
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
5. Summary Statement – Please write a summary statement assessing the student’s attitude
towards school, character, values, and special interests or talents.
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
I recommend this candidate for The American School of Doha:
Please
Complete
Character
Not
Recommended
Without
Enthusiasm
Fairly
Strongly
Strongly
Enthusiastically
Academic
Ability
Signature: ___________________________
Date: _____/______/______
Day
Month
Year
Title: ___________________________
School: ___________________________
Email Address: _______________________
Please mail, or e-mail this form directly from the school to:
Director of Admissions
The American School of Doha
P. O. Box 22090 Doha, Qatar
Phone: +(974) 4459-1511
Email: admissions@asd.edu.qa
2
PRINCIPAL/COUNSELOR/TEACHER RECOMMENDATION
Grades Pre-Kindergarten through Second
Name of Applicant: _______________________________________________
Applying for Grade: _______
Parent or Guardian
Parent or Guardian: Please write your child’s name in the space above, read and sign the following before giving
this form to the reference for your child.
I understand and agree that the information contained on this recommendation form is confidential and will be used only
in the selection of applicants and will not become part of the applicant’s permanent file. I also understand that this
completed form will not be available to applicants, parents, or anyone outside the Admissions Committee, and I waive
any right that I may have to see it.
_______________________________________
Signature of Parent or Guardian
______________________________
Date
Counselor, Principal, or Teacher
Please complete this form and return it in an envelope, or email it to the Office of Admissions listed below. This
recommendation form will be treated confidentially and will not be shared with parents. Thank you for your cooperation
and honesty.
The child’s application cannot be processed until this form is received in our Office of Admissions.
Please provide information on the student and his or her current educational program.
1. Student’s date of birth (MM/DD/YY): ______/______/______
2. Class size: _____ Student/teacher ratio: _____/_____ Number of days attended per week: ______
3. Language of instruction: ____________________________
4. Languages spoken by child in order of proficiency: _____________________________________
5. Check the student’s developmental progress in the following domains:
Above Level
At Level
Below Level
Significant Concern
Social behavior
Emotional behavior
Cognitive development
Fine motor development
Gross motor development
Speech & language development
Separation issues
6. Check the phrase which describes how this student performs the following tasks:
Outstanding
Satisfactory
Needs
Development
Using scissors
Using crayons
Writing own name
Expressing self
Assembling puzzles
Looking at books
Separation issues
Retells or pretends to read stories to you
Answers questions you ask about the story or characters
1
7. Please circle the stage of writing this student demonstrates at this time:
Scribbles
Random letters
Writes simple sentences
Pictures only
Writes beginning sounds
Writes complex sentences
Repetitive shapes
Tries to write the sounds he/she hears
Spells high frequency words
8. Please check Yes or No:
Yes
No
Does this student have special behavioral, psychological or emotional needs that might impact the
student’s chances of success in school?
Are you aware of any special testing results or evaluations?
Is this student receiving any special medication related to assisting him/her in the school setting?
Are there any special strategies or interventions that have been used with this student that you would
recommend?
Do you have any reason to suggest that this student be evaluated and /or referred for special
educational or psychological services?
Has this student ever received the services listed below? (If yes, please circle)
English as a Second Language (ESL), special education support, remedial help/tutoring,
speech therapy, occupational therapy, counseling/therapy
9. If you answered Yes to any of the above, please explain. _________________________________
_______________________________________________________________________________
_______________________________________________________________________________
10. Please check how you would rate this student’s character and work habits.
Excellent
Very
Good
Good
Needs
Improvement
Unsatisfactory
No Basis
for Rating
Respects school rules
Respects others
Uses self-discipline
Follows directions
Works independently
Use of time
Effort /motivation
Shows positive attitude
Maturity
Attendance
11. How does this student respond to conflict? ____________________________________________
______________________________________________________________________________
12. Is this student toilet trained (PK & KG students)? Yes / No / NA
13. Indicate the student’s overall academic placement (circle): Exceeds
Meets
Below
14. Please comment on the parents’ role in their child’s education, and their support of your school’s
policies and educational mission. _______________________________________________________
_________________________________________________________________________________
15. Would this student be permitted to re-enroll in your school? If no, please explain.________________
_________________________________________________________________________________
_________________________________________________________________________________
16. Principal/teacher/counselor information:
Name: ________________________ Title: _______________ Signature: _____________________
School: ______________________________ Email address: _______________________________
Please mail or e-mail this form directly from the school to:
Director of Admissions
The American School of Doha
P. O. Box 22090 Doha, Qatar
Phone: +(974) 4459-1511
Email: admissions@asd.edu.qa
2
PARENT QUESTIONNAIRE
The parent questionnaire will be looked at in conjunction with the contents of your child's academic records.
The information provided will give additional insight into your child and a better picture of your child's
academic abilities and needs. Please answer all questions as completely as you can.
Student's Full Name: _________________________________________________
My child's area(s) of strength at school include:
My child's challenges at school include:
Has the student received any of the following programs?
Date
Explanation
English as a Second Language:
____________
__________________________________
Gifted and Talented or Accelerated
____________
__________________________________
Occupational Language Therapy
____________
__________________________________
Educational or Psychological Testing ____________
__________________________________
Counseling
____________
__________________________________
Extra Academic Support
____________
__________________________________
Special Education
____________
__________________________________
Disciplinary Actions
____________
__________________________________
If your child has been in a special services program, your child's Individualized Education Plan (IEP) must
be provided.
**ASD does not have a special education program or a program for learning disabled students.
The information above is correct and accurate. Omission or failure to disclose academic or behavioral
history is cause for invalidation of application and dismissal. All fees will be forfeited.
Parent Signature: _________________________________
Date: ____________________
STUDENT HEALTH HISTORY QUESTIONNAIRE
Student’s Name: __________________________ Date of Birth: _______________
Please complete the following. If needed, the Health Clinic will follow up to obtain
further information.
1) Does your child have any history of seizure disorder, heart conditions, diabetes,
asthma or any other medical concerns?
YES or NO
2) Does your child have any congenital (birth) disorders or had any major
surgeries?
YES or NO
3) Does your child have allergies or drug sensitivities? YES or NO
If yes, please explain: __________________________________________________
4) Is your child taking any medication?
YES or NO
If yes, please explain: ___________________________________________________
5) Panadol / Ibuprofen administration (MS/HS only)
I give permission to the nurse to administer the above medications to my child for pain
relief.
YES or NO Please initial ________________
6) Emergency Medical Treatment Permission
If I, or my emergency contact person cannot be reached, ASD personnel have
my full permission to provide/seek emergency medical treatment for my child.
YES or NO
Please initial_______________
7) Two (2) Local Emergency Contact Numbers (other than parents in the event that
parents cannot be reached)
• Name and Relationship: ___________________________
Phone: ___________
• Name and Relationship: ___________________________
Phone: ___________
The above information is true and accurate to the best of my knowledge:
__________________________
Parent’s Printed Name
__________________________
Signature
____________
Date
Student immunizations must be within the American CDC/Supreme Council Of Health
standards, prior to enrollment. Please submit legible COPIES (in English) of your child’s
immunization record to the Health Clinic at ASD for review. The Nurses will screen the
records and will inform you if anything is needed.
We require documentation for the following immunizations:
• DPT (Diphtheria, Pertussis, Tetanus): 5 doses, the final dose given at 4 years of
age, then a Td every 10 years thereafter
• OPV/IPV (Polio): 4 doses, the final dose given at 4 years of age
• Measles, Mumps, Rubella (MMR): 2 doses, the first dose at age 12-15 months
• Hepatitis B vaccine (HBV): 3-dose series
• BCG (TB vaccine) or TB skin test with result within 12 months of admission
STUDENT HEALTH/PHYSICAL EXAM FORM
A Physician (not the parent) must complete this form in full
Student’s Name: ______________________________
Date of Birth: ___________________________
Examination Date: ____________________________
HEIGHT
WEIGHT
BMI
TEMPERATURE
PULSE
BP
VISUAL/AUDITORY ACUITY:
WITH GLASSES
WITHOUT GLASSES
HEARING
REVIEW OF SYSTEMS:
ENT
CARDIOVASCULAR
MUSCULO-SKELETAL
CENTRAL NERVOUS
ABDOMINAL/RECTAL
RETICULO-ENDOTHELIAL
INTEGUMENTARY
RESPIRATORY
SPECIAL OBSERVATIONS: ___________________________________________________________________________
Is there a medical reason why this student’s immunization should NOT be in accordance with the
requirements below? YES or NO If YES, please explain: ___________________________________________
Is there a BCG scar present?
YES or NO
MANDATORY MANTOUX TESTING: (IF NO BCG VACCINATION):
Date of Test: __________________ Result: __________________________
PHYSICIAN'S SIGNATURE: ______________________________________
PLACE STAMP HERE Physician’s Name: (Please Print): ___________________________________
Prerequisite for enrollment to the American School of Doha:
•
•
•
•
•
DPT (Diphtheria, Pertussis, Tetanus): 5 doses, the final dose given at 4 years of age, then a Td every 10 years
thereafter
OPV/IPV (Polio): 4 doses, the final dose given at 4 years of age
Measles, Mumps, Rubella (MMR): 2 doses, the first dose at age 12-15 months
Hepatitis B vaccine (HBV): 3-dose series
BCG (TB vaccine) or TB skin test with result within 12 months of admission
American School of Doha Calendar
As approved by the Board, December 2011
2012-2013
August 2012
Su M Tu W
1
5 6 7 8
12 13 14 15
19 20 21 22
26 27 28 29
Th
2
9
16
23
30
F
3
10
17
24
31
September 2012
Sa
4
11
18
25
Su M Tu W Th
Su M Tu W Th F Sa
1 2 3
4 5 6 7 8 9 10
11 12 13 14 15 16 17
18 19 20 21 22 23 24
25 26 27 28 29 30
Su M Tu W Th
November 2012
Su M
1
7 8
14 15
21 22
28 29
F Sa
1 2
3 4 5 6 7 8 9
10 11 12 13 14 15 16
17 18 19 20 21 22 23
24 25 26 27 28
Sa
1
2 3 4 5 6 7 8
9 10 11 12 13 14 15
16 17 18 19 20 21 22
23 24 25 26 27 28 29
30 31
May 2013
Su M Tu W Th
F
1
3 4 5 6 7 8
10 11 12 13 14 15
17 18 19 20 21 22
24 25 26 27 28 29
31
Su M Tu
1
6 7 8
13 14 15
20 21 22
27 28 29
Sa
4
11
18
25
http://www.vertex42.com/calendars/
Su M Tu W Th
W
3
10
17
24
31
Th F Sa
4 5 6
11 12 13
18 19 20
25 26 27
W
2
9
16
23
30
Th F Sa
3 4 5
10 11 12
17 18 19
24 25 26
31
Su M
1
7 8
14 15
21 22
28 29
Tu
2
9
16
23
30
W
3
10
17
24
Event or Holiday
Eid El Fitr
Teachers Return
Teacher Work Days (No Students)
First Day of School
1st Day for Pre-K & KG
PD Day (No Students)
Eid Al-Adha Break (No School)
Qatar National Day (No School)
21 Dec-5 Jan
12-Feb
31-Mar
4-13 Apr
5-8 Apr
26-May
13-Jun
14-Jun
Winter Break
National Sports Day (No school)
Easter (No School)
Spring Break
NESA Spring Educators Conference
PD Day (No Students)
Last Day of School (Students Half Day)
Teacher Work Day
Sa
1
2 3 4 5 6 7 8
9 10 11 12 13 14 15
16 17 18 19 20 21 22
23 24 25 26 27 28 29
30
School Holidays- Purple
Teacher Work Days-Red
Professional Developement Days-Brown
First and Last day of School- Yellow
PACT Tuesdays-Blue
Th F Sa
4 5 6
11 12 13
18 19 20
25 26 27
PD Days
August 27, September 27, May 26
July 2013
F
Date
19-23 Aug
25-Aug
25-28 Aug
29-Aug
3-Sep
27-Sep
25 Oct-3 Nov
18-Dec
April 2013
Sa
2
9
16
23
30
June 2013
F
3
10
17
24
31
Tu
2
9
16
23
30
January 2013
F
March 2013
February 2013
Th
2
9
16
23
30
Sa
1
2 3 4 5 6 7 8
9 10 11 12 13 14 15
16 17 18 19 20 21 22
23 24 25 26 27 28 29
30
December 2012
Su M Tu W Th
Su M Tu W
1
5 6 7 8
12 13 14 15
19 20 21 22
26 27 28 29
October 2012
F
Su M
1
7 8
14 15
21 22
28 29
Tu
2
9
16
23
30
W
3
10
17
24
31
Th F Sa
4 5 6
11 12 13
18 19 20
25 26 27
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[42]
Teacher Work Days
August 25, 26, 28
June 13, June 14 (Half Day)
Student Days 180
Teacher Days 187