LEARNING SUPPORT INFORMATION FORM
Name of child: *
Birth Date: *
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Age of Child: *
Parent/Guardian Name(s): *
Parent Email: *
Current grade in school: *
Name of Current School: *
Please describe your child’s academic, social, and behavioral strengths and weakness as you understand them: *
Was the child enrolled in a special education program? (If "Yes" Please describe the program)
Has the child been evaluated to identify possible learning disabilities and determine eligibility for placement in a special education program at the school? *
Was an Individualized Education Plan (IEP) created and/or implemented? *
If you are considering enrolling your child at AISN, what other questions or concerns do you have?
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