2024-2025 Placement Form
Click the "Save" button on the button of the form to save and return to this application.
Family Last Name
*
Parent/Guardian 1 Information
Parent 1 Full Name
*
First Name
Last Name
Parent 1 Phone Number
*
Please enter a valid phone number.
Parent 1 Email Address
*
example@example.com
Parent/Guardian 2 Information
Parent 2 Full Name
*
First Name
Last Name
Parent 2 Phone Number
*
Please enter a valid phone number.
Parent 2 Email Address
*
example@example.com
Student Information (1)
Student Name (1)
*
First Name
Last Name
Grade Entering (1)
*
Please Select
K
1
2
3
4
5
6
7
8
9
10
11
12
Parent Acknowledgement
Parent acknowledges that their child is not on grade level, does not meet requirements for Admissions into the Jewish Academy, and is in need of special education services (K-5th Grade) and/or an alternative route to high school graduation (6th-12th Grade)
*
Yes
Parent acknowledges that the Academic Enrichment Center is a separate division/school within the Jewish Academy. Students in the AEC may one day apply for the Jewish Academy if they meet academic standards needed to apply.
*
Yes
Parent acknowledges that although the Academic Enrichment Center is a separate division/school within the Jewish Academy, the parent is obligated to all contracts, rules, regulations, policies set forth by the Jewish Academy.
*
Yes
Parent Requirements
Regular Attendance: Parents are required to ensure their child's regular attendance at the Academic Achievement Center sessions as scheduled.
*
Yes
Access Additional Services: Parents are required to provide privately additional services such as speech therapy, occupational therapy, Registered Behavior Technicians (RBTs), tutoring, and/or other interventions as recommended by the Academic Achievement Center team to help their child maximize learning growth.
*
Yes
Implement Recommendations: Implement recommendations provided by the Academic Achievement Center staff, including strategies for academic support, behavior management, and skill development.
*
Yes
Support Homework and Practice Activities: Parent agrees to provide support and encouragement for their child to complete homework assignments, practice activities, or recommended exercises provided by the Academic Achievement Center.
*
Yes
Respect Policies and Procedures: Parent agrees to adhere to all policies and procedures set forth by the Academic Achievement Center, including but not limited to safety protocols, confidentiality guidelines, and scheduling procedures.
*
Yes
Provide Necessary Documentation: Parents must provide any necessary documentation related to their child's academic or developmental needs, including Individualized Education Programs (IEPs), assessments, and medical reports.
*
Yes
Apply for Special Education Scholarships and Supports: As needed by the school, Parents must actively seek and apply for special education scholarships and supports available in the community or through governmental agencies to alleviate financial burdens and access necessary resources for their child's education.
*
Yes
Kindergarten through 5th grade families must apply for special education services here: https://www.academicenrichmentcenter.com/apply-for-special-education-services
*
Yes
Kindergarten through 8th grade families must complete all requirements for their child to qualify for Family Empowerment Scholarship For Unique Abilities here: https://www.stepupforstudents.org/scholarships/unique-abilities/
*
Yes
Signature
Signature
*
Submit Registration Here
Save
Submit
Should be Empty: