The Lower School (K-7) Application for Samuel Everett School of Innovation 2024-25
Thank you for your interest in The Lower School at the Samuel Everett School of Innovation!  A team member will be be in communication and will schedule an in-person interview if the basic requirements for admission are met. 

Samuel Everett School of Innovation does not discriminate on the basis of race, gender, color, religion, national origin, age, or disability in provision of educational opportunities or employment opportunities and benefits pursuant to the requirements of Title VI of the Civil Rights Act of 1964 as codified in 42 USC 2000D, Title IX of the Education Amendments of 1972, Pub. L. 92-318, the Individuals with Disabilities Education Act Section 504 of the Rehabilitation Act of 1973, the Title II Americans with Disabilities Act of 1990, Pub. L.101-336, the Age Discrimination Act of 1975, and the Boy Scouts of America Equal Access Act.
Sign in to Google to save your progress. Learn more
Student's first name: *
Student's last name: *
Preferred name: *
Guardian's Email Address: *
Phone number: *
Guardian 1: *
Guardian 2
Does the applicant have a sibling who also is applying for admission for the 2024-25 school year? If so, what is the sibling(s) name and grade level? *
Who does the child live with? *
Home address: *
Child's date of birth: *
MM
/
DD
/
YYYY
Grade placement for the 2024-25 school year: *
Has your child ever attended a Blount County School? If so, which one most recently? *
Current school child is enrolled in? (please provide city and state) *
Have you ever applied for Samuel Everett School of Innovation before now?  *
Teaching your child from home is a great challenge, although very rewarding. Is there an adult in the home during the day that will be committed to leading a days worth of learning, each day? *
Student's are required to attend class one day a week. Will transportation or any other reason hinder your child from attending an in person class one day a week? *
Highest level of education of main guardian who will leading the child's learning: *
Does your home have access to wireless internet? *
We are excited that you are interested in The Lower School and Samuel Everett School of Innovation. Tell us more about why you are interested. *
What is your child's academic history like? *
Has your child ever received specials services from a school system? *
Does your child currently, or have they ever had an Individualized Education Plan (IEP)? *
My child's strengths are: *
What  are the learning and development goals you have for your child? *
The following have been a challenge to my child *
Required
Explanation of challenges my student faces: *
What would you like us to know about your student that we haven't asked? *
Best way to get in contact with you? *
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Loudlearning.com. Report Abuse