Pacem School Admissions
Student Information
Student Legal Name
*
First Name
Last Name
Student's preferred first name
Student Email
example@example.com
Student Birthday
*
-
Month
-
Day
Year
Date
Current Grade in School (or equivalent if homeschooled)
*
Please Select
4
5
6
7
8
9
10
11
12
Student Gender
Student Pronouns
Student is currently
*
enrolled in school
homeschooled
Number of years in current educational setting
If enrolled in school, please tell us the school name and town
Previous schools: please list school name, town, and number of years attended
Student is applying to be enrolled (if part-time, the student will be required to register as a homeschooled student with the Vermont Agency of Education.)
*
full-time
part-time
undecided
If the student is planning to be part-time, what classes are they most interested in taking?
Primary Household Information
Parent/Guardian 1 Name
*
First Name
Last Name
Parent/Guardian 1 Relationship
Parent/Guardian 1 email
*
example@example.com
Parent/Guardian 1 evening phone
*
Please enter a valid phone number.
Parent/Guardian 1 cell phone
Please enter a valid phone number.
Parent/Guardian 1 daytime phone
Please enter a valid phone number.
What is the best way to reach you?
*
email
evening phone
cell phone
daytime phone
Parent Guardian 2 Name (in the same household)
First Name
Last Name
Parent/Guardian 2 Relationship
Parent/Guardian 2 email
example@example.com
Parent/Guardian 2 evening phone
Please enter a valid phone number.
Parent/Guardian 2 cell phone
Please enter a valid phone number.
Parent/Guardian 2 daytime phone
Please enter a valid phone number.
What is the best way to reach you?
email
evening phone
cell phone
daytime phone
Student and primary household address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Does the student spend time in another household?
*
yes
no
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Additional Household Information
Household 2 Parent/Guardian Name
First Name
Last Name
Household 2 Parent/Guardian Relationship
Household 2 Parent/Guardian Email
example@example.com
Household 2 Parent/Guaridan evening phone
Please enter a valid phone number.
Household 2 Parent/Guardian cell phone
Please enter a valid phone number.
Household 2 Parent/Guardian daytime phone
Please enter a valid phone number.
What is the best way to reach you?
email
evening phone
cell phone
daytime phone
Household 2 Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Parent Admissions Questions
To help us get to know your child and family better, please answer the following questions.
Name of parent completing questions
*
First Name
Last Name
Why would you like your child to join the Pacem community?
*
Please describe your child's greatest strengths and biggest challenges.
*
Is there anything we should know that will help us facilitate your child’s academic and social growth at Pacem?
Has your child ever been eligible for special education or academic support? If so, please specify.
*
Please share with us any IEP or 504 plans that may have supported your child.
Has your child ever had any kind of educational assessment?
*
Please share with us any educational assessments that your child has.
Has your child ever been expelled or suspended from school? If so, please explain.
*
Adult Reference
Please give us contact information for an unrelated adult reference who knows the student well and can assess their strengths and challenges in an academic environment.
Adult reference name
*
First Name
Last Name
Adult reference Phone Number
Please enter a valid phone number.
Adult reference email
*
example@example.com
How does this person know your child? How long have they known your child?
*
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Release of Records
Students who are applying for our full-time program are asked to share with us some documentation of their prior work in school. Homeschooled students: please send us your prior year End-of-Year Assessement that you submitted to the Departement of Education. Students in school, please arrange to have your school records forwarded to us. In order to get records from your current school, you will need to complete a "Release of Records Form" and give it to your current school. That form is available at https://pacemschool.org/wp-content/uploads/2021/04/Release-of-Records.pdf We can also send you a hardcopy of it.
Please check here to indicate that you will send records to us.
Records will be sent from prior school
We will send End-of-year Homeschool Assessments
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At Pacem, students direct their own education and are active participants in the community. Our school works best for students who have affirmatively chosen to be here. Please tell us a little about yourself, why you would like to come to Pacem, and how you think you will contribute to the Pacem community. Full time applicants should write an essay of around 250 words. A paragraph is fine for part time applicants.
*
Student Signature: by signing below, I certify that the writing above is entirely my own work.
*
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Pacem Mission and Community Guidelines
Parents and students, please read our Mission and Community Guideline Agreement attached
Student Signature: By signing below, I agree to follow Pacem's Mission and Community guidelines
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Parent Signature: By signing below, I agree that I have read Pacem's Mission and Community Guidelines with my child, and I will support them in following it.
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