Application For Enrollment Consideration

Application For Enrollment Consideration
Thank you for taking the time to complete this application. We are looking forward to getting to know your child, and your family, better. It is our sincere desire to help each family that we meet with to determine if the Foundations program is the ideal fit for thier child. Once you have completed the application below, we will get back to you as soon as possible.
Student Name

First NameLast Name
Birth Date

MonthDayYear
Date
Gender
Grade your child is currently in (2025/2026 school year):
What grade do you plan for your child to be in next school year (2026/2027)?
Interested in enrollment for:
Campus you are interested in:
How did you hear about Foundations Cognitive Schools?

Other
If you're comfortable sharing, we would love to know the name of the friend, doctor, or school who referred you.
Parent/Guardian #1
Parent/Guardian Name

First NameLast Name
Parent/Guardian Email Address
example@example.com
Parent/Guardian Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Parent/Guardian Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian #2
Parent/Guardian Name

First NameLast Name
Parent/Guardian Email
example@example.com
Parent/Guardian Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Parent/Guardian Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Name and ages of siblings
Where do siblings attend school?
Current School - Please provide name and city of your child's current school.
Previous Schools - Please list other schools attended in the past 4 years.
Reason for leaving current school?
Has your child ever had significant disciplinary issues (suspensions, expulsions, etc.) at any school?
If Yes, please explain circumstances of what happened and when it occurred.
Has your child repeated a grade?
If yes, please please list grades and briefly describe reason.
Has your child been diagnosed with any behavior disorders, such as opposition defiance disorder, conduct disorder, etc.?
If yes, please describe
Has your child been diagnosed with any of the following learning challenges (please check all that apply):

Other
If other, please describe
Does your child struggle with any of the following (please check all that apply):
What grade level is your child currently working at in math?
If below grade level in math, what grade level are they currently working at?
What grade level is your child currently working at in writing?
If below grade level in writing, what grade level is your child currently working at?
What grade level is your child currently working at in reading?
If below grade level in reading, what grade level are they currently reading at?
How much time does your child spend on homework each night?
How does your child approach their current amount of homework?
Has your child been diagnosed with autism?
If yes, please indicate the ASD level your child was diagnosed with:
Please describe how ASD has impacted your child's success in a school setting. If your child does not have autism, please write N/A in this window.
Please indicate your child's IQ level
Please indicate if your child is currently receiving, or has in the past received, any of the following services (check all that apply):
If other, please provide name of program.
Please indicate if any of the following apply:
Does your child have any physical limitations that may impact their classroom experience?
Please provide any other information you would like us to know about your child.
What are your goals/hopes for this coming school-year?
Please upload a copy of your child's IEP, 504, or other reporting that should be taken into consideration.

Cancelof
Student Recommendation (Required for In-Person Applicants Only)

Please provide the name and email address of a teacher, principal, or school administrator who can provide a student recommendation (Foundations will email this person directly with a questionnaire to complete).
Name of former or current teacher, principal, or school administrator:

First NameLast Name
Relationship to child:
Email address of teacher, principal, or school administrator:
example@example.com
By signing below, parent confirms that all of the above information provided is true and correct to the best of their knowledge. Parent understands that failure to disclose pertinent information could lead to dismissal actions. Acceptance is based on the evaluation of completed application, testing results, and student/family interview with school administration. Parent also understands that once cumulative records are received by Foundations that, should it be determined that Foundations is not the appropriate fit for the student, acceptance/continued attendance of student may be revoked.
Parent Signature (use mouse to sign)
Type Name

First NameLast Name
Please verify that you are human
Should be Empty:

Application For Enrollment Consideration

Student Recommendation (Required for In-Person Applicants Only)