My child is applying for grade
Family Information
[swmsc_one_fourth first] Child's Full Name [/swmsc_one_fourth]
[swmsc_one_fourth]Gender MaleFemale [/swmsc_one_fourth]
[swmsc_one_fourth] Child's Preferred Name [/swmsc_one_fourth]
[swmsc_one_fourth]Date of Birth [/swmsc_one_fourth]
[swmsc_one_full first] [/swmsc_one_full]
[swmsc_one_half first] Parent/Guardian [/swmsc_one_half]
[swmsc_one_half] Relationship to child [/swmsc_one_half]
[swmsc_one_half first] Home Address [/swmsc_one_half]
[swmsc_one_half]City, State, Zip [/swmsc_one_half]
[swmsc_one_half first] Occupation [/swmsc_one_half]
[swmsc_one_half] Employer [/swmsc_one_half]
[swmsc_one_third first] Phone #1 [/swmsc_one_third]
[swmsc_one_third] Phone #2 [/swmsc_one_third]
[swmsc_one_third] Email [/swmsc_one_third]
[swmsc_one_full first]Please list the names of sibilings and others living with your child in the home.[/swmsc_one_full]
[swmsc_one_full first][/swmsc_one_full]
[swmsc_one_fourth first]Name [/swmsc_one_fourth]
[swmsc_one_fourth]Age [/swmsc_one_fourth]
[swmsc_one_fourth]School/College [/swmsc_one_fourth]
[swmsc_one_fourth]Grade/Level [/swmsc_one_fourth]
[swmsc_one_full first] Child's Previous Education[/swmsc_one_full]
[swmsc_one_fourth first] Name of School [/swmsc_one_fourth]
[swmsc_one_fourth] City/State [/swmsc_one_fourth]
[swmsc_one_fourth]Dates attended [/swmsc_one_fourth]
[swmsc_one_fourth]Grades attended [/swmsc_one_fourth]
[swmsc_one_full first]Other Information [/swmsc_one_full]
[swmsc_one_third first]Child's Activities (hobbies, sports, other) [/swmsc_one_third]
[swmsc_one_third]Artistic/Musical interest [/swmsc_one_third]
[swmsc_one_third]What language is spoken at home [/swmsc_one_third]
[swmsc_one_full first]What role does media (TV, Movies, Videos, Computer Games, etc.) play in your family life? [/swmsc_one_full]
[swmsc_one_full first]Please indicate the number of hours viewed daily and on weekends:[/swmsc_one_full]
[swmsc_one_half first]TV [/swmsc_one_half]
[swmsc_one_half]On weekends [/swmsc_one_half]
[swmsc_one_half first]Movies/Videos [/swmsc_one_half]
[swmsc_one_half first]Computer/Video Games [/swmsc_one_half]
[swmsc_one_full first] What do you consider your child's strongest aptitudes and traits of character?[/swmsc_one_full]
[swmsc_one_full first] What traits would you especially like to see strengthened?[/swmsc_one_full]
[swmsc_one_full first] Share with us any information you feel we should know about your child or your family.[/swmsc_one_full]
[swmsc_one_full first] Please list any health conditions and medications your child in taking.[/swmsc_one_full]
[swmsc_one_half first]Signature of Parent/Guardian [/swmsc_one_half]
[swmsc_one_half]Date [/swmsc_one_half]
[swmsc_one_full]Consent to Release Student Records to Pace Waldorf Academy[/swmsc_one_full]
[swmsc_one_half first] To: [/swmsc_one_half]
[swmsc_one_half] Address [/swmsc_one_half]
[swmsc_one_full first] The undersigned gives you permission to furnish information to the Pace Waldorf Academy on the undersigned student. This student either has enrolled or intends to enroll in Pace Waldorf Academy. Previous schools and/or Physicians are asked to provide all health records, behavioral records, withdrawal grades, dates of attendance or treatment, evaluations, and all achievement scores.I Agree [/swmsc_one_full]
[swmsc_one_half first] Child's name [/swmsc_one_half]
[swmsc_one_half]Current Grade [/swmsc_one_half]
[swmsc_one_third first]Parent/Guardian Printed Name [/swmsc_one_third]
[swmsc_one_third]Parent/Guardian Signature [/swmsc_one_third]
[swmsc_one_third]Date Requested [/swmsc_one_third]
[swmsc_one_full first]Records should be faxed or mailed to: Pace Waldorf Academy 16698 Lantana Harlingen, TX 78552 956-778-4295 voice 956-361-5556 fax[/swmsc_one_full]
