Name of Candidate *

(Please submit a separate questionnaire for each prospective applicant)

First Name

Last Name

Date of Birth *

MM

DD

YYYY

Name of Parent or Guardian *

First Name

Last Name

Name of Parent or Guardian #2

First Name

Last Name

Why are you considering applying to Abrome? *

(Check all that apply)

I'm bored with school

To avoid the anxiety, depression, or stress related with competitive academic environments

To avoid the social pressures and bullying associated with schooling

To find others like me

I want a safe space for BIPOC youth

I want a safe space for LGBTQ youth

I do not want to become infected with or spread Covid-19 to others

I want to wean off of compliance enhancing drugs

I want to spend my time focused on my primary interest(s)

I have an idea for a company or social enterprise that I want to execute on

To get into the college of my choice

I want to surround myself with people who believe in me and my potential to lead a remarkable life

I want to lead a remarkable life

What type of education are you looking for?

(Check all that apply)

I am focused solely on enrolling at Abrome

I am focused solely on Self-Directed Education options (e.g., Abrome, democratic schools, unschooling)

I am considering Abrome in addition to other alternative schools

I am considering Abrome in addition to other progressive schools

I am considering Abrome in addition to other private schools

I am considering Abrome in addition to other private schools and public schools

I am trying to learn what my options are

How did you hear about us? *

(Check all that apply)

Internet search

AltEd Austin

Direct mail (e.g., postcard)

Newspaper ad

Radio ad

School counselor or other school staff

Therapist / psychologist / psychiatrist

Abrome family or enrolled young person

Word of mouth

Other

Would you like to be added to our mailing list?

(You may opt out at any time)

Yes

No