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Parent Questionnaire

Thank you for your interest in enrolling your child at Garvey/Allen STEAM Academy. This form must be completed in its entirety by the Prospective Applicant's Parents/Legal Guardians. If a section doesn't apply to you or your child, please enter N/A.

 

If you are applying for multiple Achievers, a new form MUST be filled out for each one. If you have any questions, please call our Enrollment Specialist, Mrs. Palacios at (951) 384-2015 or email at [email protected]. Thank you!

Current Grade Level/ Nivel de Grado Actual*
Answer Required
Grade Applying For/ Grado Que Solicita
Answer Required
How did you hear about us? / Como se entero de nosostros?*
Answer Required

Parent Questionnaire/ Cuestionario Para Padres

In our effort to learn as much as possible about each applicant, we ask you to share your perspective with us. Thank you for your honest and objective answers./ En nuestro esfuerso papa aprender lo mas posible sobre cada solicitante, le pedimos que comparta su perspectiva con nosotros. Gracias por sus respuestas honestas y objectivas.

Has your child ever been expelled from school? / Alguna vez ha sido expulsado su hijo/hija de la escuela?*
Answer Required
Has your child ever repeated a grade? Su hijo/hija ha repetido alguna vez un grado?*
Answer Required

Social Characteristics / Caracteristicas Sociales

How would you rate your Achiever with respect to the following Social Characteristics:/ Como calificaria a su Triunfador con respecto a las siguientes Caracteristicas Sociales:

Self-Reliance /Autosuficiencia
Answer Required
Ability to get along with peers / Capacidad de llevarse bien con sus companeros/as
Answer Required
Ability to adapt/transition / Capacidad de adaptacion/transicion
Answer Required
Shyness / Timidez*
Answer Required
Do you track your child's academic and behavioral performance at school? / Sigu ested el desempeno academico y conducta escolar de su hijo/hija?*
Answer Required
Is your child self-directed with their homework? / Es su hijo/hija autodirigido con su tarea?*
Answer Required

Medical Questionnaire / Cuestionario Medico

Does your child have any allergies? / Su hijo/hija tiene alguna alergia?*
Answer Required
Is your child currently taking any medication? Esta su hijo/hija tomando algun medicamento actualmenta?*
Answer Required
Is your child's immunizations up-to-date? / Esta al dia la vacunacion de su hijo/hija?*
Answer Required
Has your child ever been/currently in counseling? / Ha estado su hijo/hija alguna vez/actualmente en consejeria?*
Answer Required

Has your child been diagnosed with any of the following? / Su hijo/hija ha sido diagnosticado con alguno de los siguientes?

Please provide complete and accurate information, such as reports and results, for all selected items. Documentation from a qualified professional should be submitted with this application or sent directly to the admissions office. Thank you./ Proporcione informacion completa y precisa, como informes y resultados, para todos los elementos seleccionados. La documentacion de un profesional calificado con esta solicitud o enviarse directamente a la oficina de admisiones.Gracias.

Attention Deficit Disorder (ADD/ADHD)*
Answer Required
Asperger's*
Answer Required
Autism Spectrum Disorder (ASD)*
Answer Required
Behavioral problems*
Answer Required
Difficulties processing information*
Answer Required
Dyslexia or other related*
Answer Required
Emotional difficulties*
Answer Required
Hearing difficulties*
Answer Required
Learning differences*
Answer Required
Obsessive Compulsive Disorder (OCD)*
Answer Required
Oppositional Defiant Disorder (ODD)*
Answer Required
Physical limitations*
Answer Required
Speech difficulties*
Answer Required

Has your child participated in any of the following?

Please provide complete and accurate information, such as reports and results, for all selected items. Documentation from a qualified professional should be submitted with this application or sent directly to the front office if applicable. Thank you.

Adaptive PE*
Answer Required
Applied Behavioral Analysis (ABA)*
Answer Required
English as a Second Language (ESL)*
Answer Required
504 Plan*
Answer Required
Occupational therapy*
Answer Required
Special Day Class (SDC)*
Answer Required
Special Education (has IEP)*
Answer Required
Special gifts or talents*
Answer Required
Speech therapy*
Answer Required
Confirmation Email