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Lincoln Alternative Academy Parent / Guardian Application 2020-2021
Parents - If your student is under 18 yrs. old, please complete this parent application for your student to be considered for enrollment at Lincoln Academy. All responses will be kept confidential and will be used as part of the intake / screening process for student enrollment at Lincoln Alternative Academy. Thank you!
Email address *
Student's Last Name *
Student's First Name *
Parent or Guardian Last Name *
Parent or Guardian First Name *
Date filled out *
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Date of birth for student *
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Age of Student *
Living Address *
Please list the town the student lives in. *
Please list who the student live with. *
Your Cell Phone Number XXX-XXX-XXXX *
Grade of Student *
Is the student currently enrolled in school? *
If you answered no, when did your student last attend school? List the Month and Year. (ex. April 2020).
What school was the student last enrolled? *
About how many days of school did your student miss last school year? *
Why was the student absent from school? *
Has the student been suspended from school? *
If your student has been suspended from school, list the reason and length of the suspension.
Has the student been suspended for an entire year? *
If your student has been suspended from school, list the reasons and for how many days. *
Please check the following criteria that applies to your student which should be considered for enrollment at Lincoln Academy. *
Required
If you marked "Other" on the previous question, please explain.
How did you hear about Lincoln Academy? *
If you answered family members to the previous question, please list their names.
Is your student currently involved in the court system? *
If you answered yes to your student being involved in the court system, please share information as to their involvement (ex. truancy court, etc.)
Has your student ever received special services for being on an Individualized Education Plan (IEP)? *
If you answered yes to your student being on an IEP, what areas of support did you receive (Math, Reading, Behavior, etc.)?
Has your student ever received special services for being on a 504 or Health Plan? *
If you answered yes to your student being on a 504 or Health Plan, why were you placed on one?
What do you feel are the problems facing your student in school? *
Does your student have any health problems, physical limitations, or other information we should be aware if your student attends school at Lincoln Academy? *
How will your student get to and from school each day? Will they need to ride the bus? *
What are the educational goals you have for your student? *
Listed are 10 character words that Lincoln Academy uses daily to teach Life Skills. Please select at least 3 character traits you would like for us to focus on with your student. *
Required
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