Enrollment Information For the admission of * First Name Last Name Student's Age Gender Male Female Other Date of birth Grade First grade Second grade Third grade Fourth grade Fifth grade Sixth grade Program 2-day Nevada City 4-day Nevada City Parent/guardian * First Name Last Name Address Address 1 Address 2 City State/Province Zip/Postal Code Country Email * Phone * Enter the best number to reach you in case of emergency (###) ### #### Student lives with Please list all siblings and other individuals living in the household (include names and ages) What schools has your child attended? * Please give length of stay and reason for change How did you hear about our school? Please describe your parenting philosophy Please describe some of the things that you like to do as a family Please describe your child's academic strengths and weaknesses Please describe your child's learning style Please describe your child's social skills Please describe your child's emotional maturity Please describe your child's personal qualities What are your child's extracurricular activities: sports, dance, martial arts, theatre, music, etc.? Does your child have an IEP/504? If your child does have an IEP or a 504, please describe the services needed to best support your child. Please understand that we do NOT provide Special Education services but will do our best to accommodate all children. Please describe your child’s educational experience. Has he/she had positive educational experiences in or out of schools? What negative educational experiences has he/she had, if any? Has your child ever been asked to leave a school? If yes, please explain. Please explain if there is any history of counseling or other therapeutic treatment (including medication) Has your child ever had issues with trust or honesty? Explain how your child relates with others. Does your child tend to get along with adults? Other children? What role does he/she play in a group setting? What do you hope for in the development of your child, both in the near future and long term? How do you see the Camino De Santiago Nature School community facilitating/encouraging this development? Is there anything else that we should know as this child is considered for admission? Thank you for sharing this information with us! Thank you!
