Emanuel Prep Scholar Application for Admission
Thank you for your interest in Emanuel Preparatory School of Math and Science. We consider parents to be an integral part of a child’s education. Your description of your child will help us understand him better.
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Email *
School Year Applying for
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Potential Scholar's First Name, Last Name, Middle Initial
Age
Date of Birth
MM
/
DD
/
YYYY
Grade applying for
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Current School
Current Grade
 Parent 1: Name 
Parent 1: Mailing Address 
Parent 1: Street Address
Parent 1: Home Phone
Parent 1: Business Phone
Parent 1: Cell Phone
Parent 1: Email Address
Parent 2: Name 
Parent 2: Mailing Address 
Parent 2: Street Address
Parent 2: Home Phone
Parent 2: Business Phone
Parent 2: Cell Phone
Parent 2: Email Address
If parents are separated or divorced, with whom does the applicant reside?
Sibings Name and Date of Birth
Was your child receiving Special Education Services based on an  Individualized Education Plan (IEP)?
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  Has your child had any significant academic difficulties? If yes please explain.

Has your child ever been dismissed, suspended, or withdrawn from school, placed on probation, or incurred other serious or repeated disciplinary action? If yes please explain.


Are there any special circumstances in your child’s life you would like us to know about?

1. Describe your child, including strengths and challenges, motivation, and needs.

a. General temperament           b. Emotional development        c. Social relations (adults & peers)

 d. Physical stamina/health      e. Distinctive abilities/interests (artistic, athletic, etc.) 

 f. Academic skills (applicants to grades 1-7 only)
2. Describe your child’s previous school and/or daycare experiences. What were the positive aspects? What were the difficulties?
3. Describe the activities you do as a family.
4. Describe the ways in which you support the education of your child at home.
5. Describe the ways your child utilizes unstructured time.
6. Describe any aspects of your family history or structure that are significant to your child’s schooling (e.g., marital separation, divorce, death of a family member, gain of a new family member, change in financial state, change in residence).
7. What are your short-range and long-range goals for your child’s education?

8. Has your child ever been referred for developmental/educational testing? Has he ever worked with a tutor or learning specialist? If so, please describe briefly and provide the Admissions Office with all testing results.


9. Why would you like your child to attend Emanuel Preparatory  School of Math and Science?
Name of Potential Scholar's Current Teacher
Name of Potential Scholar's Current School Phone
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