New Student Application

Student's Full Name: *

Date of Birth: *

Grade in September 2023: *

Age in September 2023: *

Home Street Address: *

Address Line 1 Address Line 2

School District: *

School Attending: *

Home Phone: * Invalid Phone

Parent Cell Phone: * Invalid Phone

Family Email Address: * Invalid Email

Student Email Address: * Invalid Email

Has your child received the required childhood vaccines to enter public school? *

Allergies/Medications: *
Please describe:

Father's Name: *

Father's Cellphone: * Invalid Phone

Profession:
(past and/or current)

College(s) Attended:

Degree(s) Earned:

Work Phone: Invalid Phone
(enter as 111-222-3333)

Mother's Name: *

Mother's Cellphone: * Invalid Phone

Profession:
(past and/or current)

College(s) Attended:

Degree(s) Earned:

Work Phone: Invalid Phone
(enter as 111-222-3333)

Cell Phone: * Invalid Phone

Home Phone: * Invalid Phone

Has your child's academic aptitude been tested by a public school or private service?

If "yes", did the assessment classify your child as a gifted learner?

Overall IQ Score: *

Is your child currently enrolled in an enrichment program?

If "yes" to the above question, which program?

Please Describe:

If your child has not been tested, please explain your child's characteristics that might indicate "giftedness."

If applicable, please check one or more of the following characteristics of gifted toddlers:

Parent Narrative About Child: *
(Please write a narrative about your gifted child: personality traits, talents, interests, areas of more enrichment needed, books currently reading, writing ability, unfavorite and favorite subjects in school, social relationships, emotional maturity and expectations of the VEG Program.)