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

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

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

Medical Questionnaire / Cuestionario Medico

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

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

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