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					                                    Bellaire High School
                          International Baccalaureate Registration

              Last Name                            First Name           Middle Name        Sex       Date of Registration

     Street Address                 Apt. #                 City               State                      Zip

Home Phone (area code)         Date of Birth           Ethnicity           1st language                2nd language

    Father’s Name               Work phone          Mother’s Name           Work Phone              Student lives with
                                                                                                 □ Both □ Mother
                                                                                                 □ Other □ Father
           Parent email                             Student email                Grade level

 Mark the exams that you are registering for this examination year. If you are in 11 grade, you may
 take up to 2 SL exams. If you are in 12th grade, you may take a combination of 4 HL and 2 SL exams
 or 3 HL and 3 SL exams.

  Foreign Language                           Sciences                                 Mathematics
      SL Arabic                              SL Biology                     SL Math (calculus)
      SL French                              SL Chemistry                   HL Math
      SL German                              SL Physics                     SL Computer Science
      SL Hebrew                              HL Biology
      SL Hindi                               HL Chemistry
      SL Japanese                            HL Physics                                 The Arts
      SL Mandarin                                                           SL Art
      SL Russian                             Social Studies                 SL Music Performance
      SL Spanish                             SL Economics                   SL Theater
      HL Arabic                              SL Geography                   HL Art
      HL French                              SL Psychology                  HL Music Performance
      HL German                              HL Economics                   HL Theater
      HL Hebrew                              HL Geography
      HL Hindi                               HL Psychology                  Theory of Knowledge
      HL Japanese                                                           Extended Essay in
      HL Mandarin                            English                        _________________________
      HL Russian                             SL English (11th)              with _____________________
      HL Spanish                             SL English (12th)
                                             HL English (12th)
                                             T.O.K. (12th)
                              Bellaire High School
                    International Baccalaureate Registration

Name: _____________________________ Grade ______________

Examination Fees:
Certificate/Retake Candidate                $ 201.00 ________
Anticipated Candidate (1st year)            $ 55.00 ________
Diploma Candidate (2nd year)                $ 25.00 ________
Diploma Candidate (all 6 exams)             $ 80.00________

HL or SL subject exam    $ 40. ea. x ______ = $    ________
Extended Essay                                $45.00 ________
Theory of Knowledge                           $25.00

                                          Total Due $ ______________

                                          Total Paid $ ______________ Date ________

Please Note:
There are no registration refunds or transfers of
registration after November 1st

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