Please enable JavaScript in your browser to complete this form. - Step 1 of 5Chicago Friends School cherishes the individuality and uniqueness of each of its students and considers the whole child during the admission process. All the information you provide is confidential. Thank you for your thoughtful evaluation.Student's Name *FirstLastCurrent Grade Level *Fifth GradeSixth GradeSeventh GradeParent/Guardian Name *FirstLastRelationshipMotherDadOtherIf other is chosen, please explain below. Further explanation of relationshipStudent's Address *Address Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeNextHow long have you known the child?In what capacity?What is the number of students in your classroom? Selected Value: 0 What are the first three words that come to mind to describe this child? *PreviousNextSOCIAL-EMOTIONAL, BEHAVIORAL DEVELOPMENT SECTIONWe recognize that children develop at different paces along a developmental continuum. If the child demonstrates concern in an area of development, please comment including whether this is a possible area of concern or if the child has been formally evaluated and receives special services. Forms Friendships and Interacts appropriately with peers *ExceedingAge-AppropriateProgressingAreas of ConcernPlease choice oneRespects Others, Including Personal Boundaries, Sensitivities and Feeling and Properties. *ExceedingAge-AppropriateProgressingAreas of ConcernPlease choice oneDemonstrates Emotional Self-Control Appropriate Emotional Reactions. *ExceedingAge-AppropriateProgressingAreas of ConcernPlease choice oneTells The Truth *ExceedingAge-AppropriateProgressingAreas of ConcernPlease choice oneAdheres to Classroom and School Norms Appropriately. *ExceedingAge-AppropriateProgressingAreas of ConcernPlease choice oneIf there is additional information or concerns please share. PreviousNextACADEMIC DEVELOPMENT Demonstrates Age Appropriate Reading, Writing and Expressive Language Skills. *ExceedingAge-AppropriateProgressingAreas of ConcernPlease choice oneThinks Quantiatively and Applies Mathematical Skills Appropriately. *ExceedingAge-AppropriateProgressingAreas of ConcernPlease choice oneCompletes Task When Assigned in Designated Time Periods With Appropriate Levels of Support. *ExceedingAge-AppropriateProgressingAreas of ConcernPlease choice oneDemonstrates Creativity and Imagination. *ExceedingAge-AppropriateProgressingAreas of ConcernPlease choice oneExhibits Problems Solving Abilities and Independence. *ExceedingAge-AppropriateProgressingAreas of ConcernPlease choice oneAttends to Content, Asks Relevant Questions. *ExceedingAge-AppropriateProgressingAreas of ConcernPlease choice oneContributes Appropriately in Group Setting. *ExceedingAge-AppropriateProgressingAreas of ConcernPlease choice oneMonitors Own Learning, Seeks Help When Appropriate. *ExceedingAge-AppropriateProgressingAreas of ConcernPlease choice oneIf there is additional information or concerns please share. (copy)PreviousNextHave you recommended to the parents/guardians that this student be evaluated for special learning and/or behavioral needs? If yes, please comment. Does this student have a learning or behavioral difference that impacts their learning or experience in the classroom? If yes, please describelDo you have any comments or concerns about this student's physical development ro physical skills? Does this student have any particular affinities or interests you would like to share with us?Is there any additional information that would be helpful to us in our evaluation of this applicant? Parents/Gaurdian are an important part of our relationship with the student. Please share with us any thoughts you have regarding this applicant's family, including their involvement in your school. *Section DividerMay we contact you if we have additional questions? *YesNoTeacher's Name *FirstLastCell Phone *School's Name *School's Address *Address Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeWork Email *School's PhoneSection DividerThank you! Your perspective is important to us. Submit
