Connections School Of Atlanta Instructions for Admissions Application

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1 Connections School Of Atlanta Instructions for Admissions Application 1) All interested families must first attend an informational interview to begin the application process. Informational interviews are for parents only and do not include prospective students and/or siblings. Schedule an informational interview by ing or calling ) Submit your application along with a $150 application fee by check or credit card. Mail: Connections School of Atlanta 111 Cottonwood Place Decatur, GA A complete application includes: The form below Any written evaluations performed within the last two years that you feel are relevant A current transcript or its equivalent The teacher questionnaire, which the teacher can mail directly to Connections, or return to you in a sealed envelope signed across the flap for inclusion with the rest of the application. 3) We will contact you within approximately 2-3 weeks of receiving the complete application to schedule the family and student interviews. Family interviews include all members of the family who are authorized to make decisions on the student s behalf. Family and student interviews occur separately and simultaneously. Please allow at least 60 minutes for the interview process. 4) We will notify you of our admissions decision within approximately 2-3 weeks of the completion of the interview process. 1 of 15

2 Connections School Of Atlanta Application for Admission School Year Date / / of Applicant Last First Middle Nickname Age Date of Birth / / M F Student s Home : Street City State Zip Home Connections School of Atlanta admits students students of any race, color, national and ethnic origin to all the rights, privileges, programs and activities generally accorded or made available to students at the school. It does not discriminate on the basis of race, color, national and ethnic origin in administration of its educational policies, admissions policies, scholarship and loan programs, and athletic and other schooladministered programs. 2 of 15

3 Family Information of Parent Home Street City State Zip Home Cell Work Occupation Employer Employer of Parent Home Street City State Zip Home Cell Work Occupation Employer Employer 3 of 15

4 Family Information (cont d) Marital Status: Married Divorced Separated Other Siblings Age Current School Age Current School Age Current School Age Current School Emergency Contacts Relationship to child Home Street City State Zip Home phone Cell phone Work phone Relationship to child Home Street City State Zip Home phone Cell phone Work phone 4 of 15

5 Educational History Current School Contact Person Number Dates of Attendance Reason for Leaving How does your child feel about his/her current school experience? Previous School Contact Person Number Dates of Attendance Reason for Leaving Reason for applying to Connections School of Atlanta 5 of 15

6 Getting to Know Your Child Discuss what is special and unique about your child. Describe his/her current interests, passions and strengths. At Connections we are focused on creating an environment where each child can learn optimally. Please describe his/her learning style, and the environment and strategies you think your child needs to maximize his/her learning potential. Please describe what you are hoping for from the Connections educational experience for your child. Academically Socially Emotionally 6 of 15

7 Social/Emotional History Please describe how comfortable your child is in a group. Please list examples and different contexts (birthday parties, classroom, family gatherings, crowded environments, etc.) Please describe how your child interacts, communicates and plays with you. Please describe how your child interacts with siblings. Please describe how your child interacts with peers and kinds of play he/she prefers. Include information about the ages of the people your child chooses to play with; if your child tends to be a leader, follower, or by his or herself; also include favorite play themes. 7 of 15

8 Social/Emotional History (con d) When your child is upset, what are the usual triggers (physiological, emotional, sensory, other)? Please describe what his/her reactions look like when upset. What does your child do to try and calm his/herself? What strategies work from you to help calm/soothe him/her? How long does it take your child to recover when upset? Does your child exhibit anxiety? If yes, please describe what that looks like, what you think the triggers are, and what you do to help support his/her anxiety. Does your child exhibit impulsive behavior that you feel could be potentially dangerous to him/ her and/or others? If yes, please describe. 8 of 15

9 Social/Emotional History (con d) Please describe how your child makes transitions between people, activities or environments. Include level of independence during transitions, need for transitional objects and/or need for advance preparation for schedule changes. Does your child need reminding to initiate or complete familiar tasks? If yes, please describe strategies of how you support this area. Please describe your child s reaction to movement. Include information about the types of movement your child likes and dislikes, and the frequency with which your child seems to seek or avoid movement. Self-stimulatory behavior, also known as stimming, is the repetition of physical movements, sounds, words and/or repetitive movement of objects. If your child has a preferred stim, please describe what that looks like (singing, scripting, chewing, flapping, pacing are all examples). 9 of 15

10 Social/Emotional History (con d) Please describe a typical day for your child. Include information regarding all activities such as morning routine, transitions to and from school, and behaviors that might be seen during a typical day. Does your child utilize non-traditional methods of communication? yes no If so, please explain in detail: 10 of 15

11 Medical History (fill out where applicable) Child s Physician Child s Psychiatrist Child Psychologist Child s Counselor Please describe any allergies your child has: Does your child have a diagnosis? Does your child know his/her diagnosis? Is your child currently taking medication? Yes No Yes No Yes No of Medication(s) Dose Dose Dose 11 of 15

12 Therapeutic Services Occupational Therapist Speech/Language Therapist Physical Therapist Floortime Therapist Other 12 of 15

13 Parent Statement Please describe what role you plan to play in your child s education at Connections. Include information about your ideal time commitment, responsibilities, level of involvement and relationship with the school. Please provide this information for each parent/guardian who interacts with the child. You may attach extra pages if necessary. 13 of 15

14 Connections School of Atlanta Applicant Teacher Questionnaire Please complete and either return to the family in a sealed envelope with your signature across the flap, or mail the completed form directly to: Connections School of Atlanta, 111 Cottonwood Place, Decatur, GA Date: Student : Teacher /Title (include subjects taught): Please paint a picture of what this student looks like in your classroom. List what supports the student needs to be successful in each of the following areas. Include all strategies, accommodations, and classroom tools used. Feel free to attach additional pages if necessary. Academic: Social: Emotional: Sensory Communication: Physical (gross and fine motor): Please list three goals you have for this student. Please describe any testing accommodations this student receives. 14 of 15

15 Please give an average percentage of how much time this student spends in the large group vs. small group vs. one-on-one during the school day: Large group: Small group: One-on-one: Please describe when and why the student receives 1:1 support: Does the student have a facilitator? Y N Please list all curricula used this year and note at what grade level the student is working. Please list any gifts that this student may possess. Please list what you believe are this student s strengths. Please list what you believe are this student s challenges. Please share any further information you believe we should know about this student. Do we have permission to contact you with any questions regarding this form or about this student? Y N If so, please provide your preferred contact information: 15 of 15

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