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About Us
Admissions
Elementary School
Middle School
High School
Blog
Contact Us
- Request a Tour
- Ask The Expert

Admissions Application

Attach photo of applicant(Required)

Max. file size: 5 MB.

APPLICATION FOR ADMISSION

TODAY’S DATE:

MM slash DD slash YYYY

Student Information

Legal Name: (First, Middle, Last)(Required)

Nickname:(Required)

DOB:(Required)

Age:(Required)

Social Security Number:(Required)

Home Street Address:(Required)

Apt. No.:(Required)

City:(Required)

State:(Required)

Current School/Phone Number:(Required)

Zip:(Required)

Current Grade:(Required)

Contact at Current School:(Required)

Current Status of Parent(s)/Guardian(s):

Married

Single Parent

Widowed

Domestic Partners

Divorced (if divorced, please indicate which parent has legal custody of child:

Mother

Father

Both

If parents do not live in the same household, with whom does the child reside?

What concerns brought you to Aaron School?How did you hear about our school?

Parent/Guardian Information

Parent/Guardian 1:

Name:

Relation to student:

Mother

Father

Guardian

Other

Home Street Address:

(Check box if same as student)

City:

State:

Zip:

Apt. No.:

Home Phone:

Work Phone:

Parent’s Profession and Workplace:

Cellular Phone:

Email Address:

Parent/Guardian 2:

Name:

Relation to student:

Mother

Father

Guardian

Other

Home Street Address:

(Check box if same as student)

City:

State:

Zip:

Apt. No.:

Home Phone:

Work Phone:

Parent’s Profession and Workplace:

Cellular Phone:

Email Address:

Persons in Household

Name:

Relation to student:

Mother

Father

Guardian

Step Parent

Caretaker

Other:

Sibling

Name:

Relation to student:

Mother

Father

Guardian

Step Parent

Caretaker

Other:

Sibling

Name:

Relation to student:

Mother

Father

Guardian

Step Parent

Caretaker

Other:

Sibling

Name:

Relation to student:

Mother

Father

Guardian

Step Parent

Other:

Sibling

Developmental and Medical History

Pediatrician

Phone

Is your child adopted?

Country of Birth

Age at adoption

(If your child was adopted, please include as much developmental history as is known to you on a separate sheet.)

Were there any complications during pregnancy or birth or after?

Was your child full term?

Yes

No

If No, in what week was he/she born?

Weight

Describe your child as an infant(Check all that apply):

Active

Colicky

Content

Unresponsive

Fussy

At what age did your child?: Sit

Walk

Say first words

At what age did you suspect your child had a developmental delay?

Is your child on medication?

Yes

No

Has your child had any surgical or medical procedures, i.e. adenoids or tonsils removed?

Yes

No

If yes, explain

Intervention History

Developmental and Medical History

Academic Support

Audiological/Hearing Service

PROMPT Therapy

Occupational Therapy

Therapeutic Listening

Physical Therapy

Counseling Services

SEIT Services

Peer/Social Skills Group

Speech/Language Therapy

Cognitive Behavioral Therapy

OTHER

Please list the therapists, frequency of treatment (including private and school sessions) and contact information:

Has your child been evaluated/diagnosed?

Yes

No

By whom and when?

Diagnosis

I give representatives of AaronSchool permission to speak to the professionals named above regarding my child’s learning styles and progress.

Your Name:

Relationship to applicant:

Signature

Date

MM slash DD slash YYYY

School History (Please list all schools attended)

Early Intervention :

Dates Attended

Preschool/Nursery :

Dates Attended

Kindergarten :

Dates Attended

Elementary :

Dates Attended

Middle School :

Dates Attended

High School :

Dates Attended

Did your child repeat a grade?

Yes

No

Grade Repeated Please explain

Social and Emotional Development

How does your child respond to new situations?

What is your child like at home? (Include activity level and relation to siblings)

Does your child have difficulty with transitions from one activity to another?

Yes

No

Explain

Does your child have frequent tantrums?

Yes

No

How long do tantrums last?

Explain

Briefly describe your child’s personality? What activities does he or she like best? What activities does he or she avoid? Please include his/her strengths, interests, talents and future goals for your child. Please feel free to elaborate beyond these qualities.

Why are you applying to Aaron School for your child?

If you are applying to the High School, what are your desired outcomes for your child following High School graduation?

Who filled out this form?

Relationship to the applicant?

Thank you for taking the time to complete this application

Δ

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New York, NY 10017
Phone (212) 867-9594
Fax (212) 867-9864

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