Admissions Interest Form
The Admissions Interest Form asks basic information about your child. If you have academic and/or neuropsychological testing available, we ask that you please upload it here or send it to our Diagnostician at admissions@thestanthonyschool.com. Upon submission, our team will carefully review your child’s information + testing and determine if our program would be appropriate for your child’s needs. Our Admissions Team will follow up regarding next steps as soon as possible.
Parent/Guardian Name 1:
*
First Name
Last Name
Parent/Guardian Name 2:
*
First Name
Last Name
Is your child adopted?
*
Yes
No
Phone Number:
*
Please enter a valid phone number.
Email:
*
example@example.com
Address:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Student's Name:
*
First Name
Last Name
Student's Age
*
Please Select
8
9
10
11
12
13
14
15
16
17
18
Student's Current Grade
*
Please Select
3
4
5
6
7
8
9
10
11
12
Is your child currently working at grade level?
*
Yes
No
Student's Current School:
*
Last Year's School (if different):
Are you thinking of changing schools now?
*
Presenting Issues (academic, social, behavioral):
*
Do you have testing results? Academic and/or Neuropsychological Testing, i.e. Full Individual Evaluation (FIE) completed by school district, or testing completed by private facility.
*
Yes
No
Source of testing results:
*
If you have testing results, please upload below. (You may also send via email to our Diagnostician: lexie@thestanthonyschool.com) *All testing submitted will remain confidential and shall not be disclosed to any other parties outside of the St. Anthony School. All testing will be protected within our secure system.*
Browse Files
Drag and drop files here
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Password for Testing:
*
If applicable.
Current Medications:
*
Name of Prescribing Doctor:
*
Outside Therapies:
*
How did you hear about us?
*
Google Search
Professional Referral
Friend/Family
Facebook/Instagram
Other
Professional Referral Source:
*
If applicable.
*
I have reviewed the step-by-step admissions process as well as the tuition information listed on the school website. I am aware that should a student visit be scheduled, a non-refundable $250 application fee will be due prior to the student visit date.
Submit
Should be Empty: