Wingra School Student Application

Wingra School Student Application
Applicant Information
Name of Applicant

First NameMiddle NameLast Name
Applicant's Birth Date

MonthDayYear
Date
Gender
Applying for Grade
Academic Start Year
Home and Household Information
Primary Home Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Does the student reside in this household?
Does the applicant have an additional household with legal guardianship?
How many siblings, if any, does the applicant have?
How did you hear about Wingra School?
First Parent/Guardian Information
First Parent/Guardian Name

First NameMiddle NameLast Name
First Parent/Guardian Relationship to Applicant
Is this parent/guardian an emergency contact?
Is this parent/guardian financially responsible?
Should this parent/guardian be sent school correspondences?
First Parent/Guardian Primary Phone
Please enter a valid phone number.Format: (000) 000-0000.
First Parent/Guardian Secondary Phone
Please enter a valid phone number.Format: (000) 000-0000.
First Parent/Guardian Primary Email
example@example.com
Is this parent/guardian an alumnus of Wingra School?
First Parent/Guardian Employment Status
First Parent/Guardian Title/Occupation
First Parent/Guardian Employer
Second Parent/Guardian Information
Is there a second parent or legal guardian in this household?
Second Parent/Guardian Name

First NameMiddle NameLast Name
Second Parent/Guardian Relationship to Applicant
Is this parent/guardian an emergency contact?
Is this parent/guardian financially responsible?
Should this parent/guardian be sent school correspondences?
Second Parent/Guardian Primary Phone
Please enter a valid phone number.Format: (000) 000-0000.
Second Parent/Guardian Secondary Phone
Please enter a valid phone number.Format: (000) 000-0000.
Second Parent/Guardian Primary Email
example@example.com
Is this parent/guardian an alumnus of Wingra School?
Second Parent/Guardian Employment Status
Second Parent/Guardian Title/Occupation
Second Parent/Guardian Employer
Educational History
Current Grade
Most Recent School or Daycare Attended
Age(s) While Attending
School Address
Current Teacher's Email Address
example@example.com
Parent Narrative and Child Development
Describe your educational priorities. Tell us why you feel Wingra School is an ideal learning environment for your child.
What do you enjoy about your child?
What are your child's special interests and talents?
Discuss your child's previous school or preschool experiences and how your child responded to those experiences.
Describe your child as a learner. What comes easily for your child? What is more challenging?
Describe how your child interacts with other children.
Describe how your child interacts with adults.
Describe any concerns you have or have had about your child's intellectual, social, or emotional development.
What opportunities has your child had for interacting with other children outside of school? Describe your child's involvement in any organized programs, sports, clubs, or lessons.
How does your child respond when faced with a challenging task?
How does your child express anger? How do you respond?
Briefly describe your approach to parenting and discipline.
Discuss any life events, such as moves, hospitalizations, injuries, grief or loss experiences, and or family configuration changes that have had a significant influence on your child.
Describe any allergies, medical conditions, speech or hearing challenges, or other factors that may affect your child's educational experience.
Have your child's teachers or caregivers ever expressed concern about any aspect of your child's development, learning or behavior?
Briefly describe the teachers or caregivers concerns.
Has your child had any academic or behavioral evaluations by a private evaluator or by a school district?
Has your child been found eligible for a 504 or IEP? (If yes, please email a copy of the latest report to Johanna at johanna@wingraschool.org)
Has your child had a referral to or received any of the following services?

Other
Have you applied previously?
Consent and Signature
There is a $100.00 application fee. Please indicate how you would like to pay the fee below.
Parent/Guardian Full Name (for signature)

First NameMiddle NameLast Name
I agree to the terms and conditions stated above.
Parent/Guardian Signature
Should be Empty:

Wingra School Student Application

Applicant Information

Home and Household Information

First Parent/Guardian Information

Second Parent/Guardian Information

Educational History

Parent Narrative and Child Development

Consent and Signature