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Enrollment
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Step
1
of 4
Consideration for School Year
*
Entering Grade
*
Preschool
Kindergarten
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Did anyone refer you to Oakstone Academy?
*
Yes
No
If so, please list who below
*
Student Name
*
First
Middle
Last
Student Date of Birth
*
Address
*
Address Line 1
Address Line 2
City
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Primary Spoken Language
*
How many siblings attend Oakstone, if any?
Selected Value:
0
Sibling One
*
First
Last
Sibling Two
*
First
Last
Sibling Three
*
First
Last
Sibling Four
*
First
Last
Sibling Five
*
First
Last
Sibling Six
*
First
Last
Sibling Seven
*
First
Last
Sibling Eight
*
First
Last
Sibling Nine
*
First
Last
Sibling Ten
*
First
Last
Are there any health needs of which we should be aware that will help us plan and provide for your student’s educational experience?
*
Yes
No
If so, what are they?
*
Does your child have a diagnosis?
*
Yes
No
If so, please put it below
*
Home School District
*
Person(s) financially responsible for the student
*
Who does the child reside with?
*
Both Parents
Mother
Father
Other
If other, please explain
*
Mother/Father Info
Name
*
First
Middle
Last
Address
*
Address Line 1
Address Line 2
City
--- Select state ---
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
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North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Email
*
Phone
*
Occupation
*
Mother/Father Info
Name
*
First
Middle
Last
Address
*
Address Line 1
Address Line 2
City
--- Select state ---
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Email
*
Phone
*
Occupation
*
Family Status
*
Divorced
Separated
Married
Other
If other, please explain:
*
Previous
Next
Does your child have...
If applicable, please upload supporting documentation for each of the following. If you do not have a document, please select "No". If you are having issues uploading documents, email them directly to dgebert@ccde.org with your child's name followed by "documents" in the subject. Example: John Doe's Documents
Current Report Card:
*
Yes
No
File Upload
*
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You can upload up to 5 files.
IEP and ETR:
*
Yes
No
File Upload
*
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File Upload
*
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504:
*
Yes
No
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*
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Any Medical Conditions:
*
Yes
No
If yes, what are they?
*
Intervention Program:
*
Yes
No
File Upload
*
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Home Program:
*
Yes
No
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*
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Tutoring:
*
Yes
No
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*
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Private Evaluation:
*
Yes
No
File Upload
*
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Counseling/Therapy:
*
Yes
No
File Upload
*
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You can upload up to 5 files.
Speech Therapy:
*
Yes
No
File Upload
*
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You can upload up to 5 files.
Occupational Therapy:
*
Yes
No
File Upload
*
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Physical Therapy:
*
Yes
No
File Upload
*
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Medications:
Yes
No
If yes, what are they?
Previous
Next
Why have you decided to change schools?
*
What are your child’s greatest strengths?
*
What does your child struggle with?
*
Is there any other information you would like to mention that is not included in this form?
Contact
*
First
Last
Contact Email
*
Contact Phone
*
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