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New Student Information
New Student Supplemental Information
Student First Name *
Student Last Name *
Current School *
City of Current School *
First Name of Parent Filling Out This Form *
Last Name of Parent Filling Out This Form *
Does your child have any learning difference or diagnosed disability (ADD, ADHD, Aspergers, etc.)? *
Yes
No
If yes, please explain.
Does your child have any other academic or social sensitivity of which to be aware? *
Yes
No
If yes, please explain.
Does your child qualify for special education services? *
Yes
No
If so, is there a current IEP?
Yes
No
Mark any of the following programs in which your child has previously participated.
Resource Program
IEP
504
Accommodation Plan
Special Tutoring
Offer any additional information about the previous question that might be helpful.
Do you plan on having your child tested for any learning, emotional or behavioral needs soon?
Does your child have any health problems (physical or mental) that affect school performance?
Yes
No
Does your student have a disciplinary history that we should be aware of?
If yes, please explain.
If you answered “yes” to any questions above, do you expect special academic support from CA?
Yes
No
If yes, what kind of support?
List your child's academic passions or interests.
List extracurricular activities in which your child may be interested.
Is there anything else that we should know to help your child succeed at CA?
Enter Your Email Address: *
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