Kickapoo Valley Forest School Application for Admission. School Year 2021-2022
Mailing Address: 301 W. Adams St. La Farge, WI 54639
Website: www.kickapoovalleyforestschool.org
Phone: 608-625-6888
La Farge School District Phone: 608-625-2400
Email: kvfs@lafarge.k12.wi.us
● Students who do not reside in the La Farge School District (LFSD) must also open enroll into the LFSD by completing the Wisconsin DPI open enrollment application between February 1 – April 30, 2021.
Found here: https://dpi.wi.gov/sites/default/files/imce/forms/pdf/f9410.pdf

Please fill out ALL of the following questions. If the question is not applicable please type in "none"
Child's Legal Name: First, Middle, Last *
Child's Date of Birth *
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Gender *
Grade applying for during the 2021-2022 *
Parent/Guardian 1 Name: *
Parent/Guardian 1 Occupation: *
Is Parent/Guardian 1 a member of the US Military? *
Parent/Guardian 1: Date of Birth *
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Parent Guardian 1: Relationship to this student *
Parent/Guardian 1: Address with city/state/zip code *
Parent/Guardian 1: Home Phone #
Parent/Guardian 1: Cell # *
Parent/Guardian 1: Work #
Parent/Guardian 1: Email Address *
Parent/Guardian 2: Name
Parent/Guardian 2: Occupation
Is Parent/Guardian 2 a member of the US Military?
Clear selection
Parent/Guardian 2: Date of Birth
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DD
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YYYY
Parent/Guardian 2: Relationship to this student.
Clear selection
Parent/Guardian 2: Address with city/state/zip code
Parent/Guardian 2: Home Phone #
Parent/Guardian 2: Cell #
Parent/Guardian 2: Work #
Parent/Guardian 2: Email Address
Other Caregiver Name *
Other Caregiver Phone Number *
Are there other siblings also applying to the Kickapoo Valley Forest School? *
If there are other siblings also applying to KVFS: please list name(s) and grade(s). If not additional siblings are applying, list "none". *
School District in which you reside *
Students current grade level *
Current school/ child care center name/Dates attended/Teacher Name
Is this student (Choose one or more). *
Is the first language used by this student English? *
If English is not the first language used, what is the preferred language?
When at home, does the student use a language other than English more than half of the time? *
To ensure appropriate placement and necessary support services, please provide the following information about your child’s current and previous educational program. Important Note: If your child has an IEP, we will need a copy of that document, and the assessment that created IEP eligibility. If an IEP is developed after the date that you submit this application, please send us a copy of the new IEP and assessment as soon as it is available. Is this student currently enrolled in special education / has an IEP (Individual Education Plan)? *
If your child is receiving special education services please describe what kind of service this student is receiving from the IEP (Individual Education Plan),
Does your child have a 504 Accommodation Plan? *
If your child has a 504 Accommodation Plan, please explain,
Please check any medical conditions that your child may have: *
Required
Other condition(s) or alert information that staff should be aware of requiring special care. Please specify. If none exist, list "none". *
Additional information that would be helpful to teachers/staff.
Write your name to acknowledge the acceptance of this statement: I, ________________________________________________, hereby certify that I am the parent or legal guardian of the child named above, and that all of the information given in this application is true to the best of my knowledge. I authorize The Kickapoo Valley Forest School to contact any care provider or school that my child has attended for additional information about my child. *
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