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 *Pre-KindergartenKindergartenFirst GradeSecond GradeParent/Guardian Name *FirstLastRelationshipMotherDadOtherIf other is chosen, please explain below. Further explanation of relationshipStudent's AddressAddress 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? *PHYSICAL 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. Gross Motor DevelopmentExceedingAge-AppropriateProgressingAreas of ConcernPlease choice oneFine Motor DevelopmentExceedingAge-AppropriateProgressingAreas of ConcernPlease choice oneSpeech Development/Clarity of SpeechExceedingAge-AppropriateProgressingAreas of ConcernPlease choice oneIf there is additional information or concerns please share. PreviousNextSOCIAL-EMOTIONAL DEVELOPMENTSensitivity Towards Other's Feelings/Respect for Individual DifferencesExceedingAge-AppropriateProgressingAreas of ConcernPlease choice oneDemonstrates Concern for Others ExceedingAge-AppropriateProgressingAreas of ConcernPlease choice oneForm FriendshipsExceedingAge-AppropriateProgressingAreas of ConcernPlease choice oneAppropriately Initiates and Responds to Peer Interaction ExceedingAge-AppropriateProgressingAreas of ConcernPlease choice oneRespects Personal BoundariesExceedingAge-AppropriateProgressingAreas of ConcernPlease choice oneRespects Property of OthersExceedingAge-AppropriateProgressingAreas of ConcernPlease choice oneSeek Positive Relationships with AdultsExceedingAge-AppropriateProgressingAreas of ConcernPlease choice oneDemonstrate Self-ControlExceedingAge-AppropriateProgressingAreas of ConcernPlease choice oneAdjusts to TransitionsExceedingAge-AppropriateProgressingAreas of ConcernPlease choice oneExpress Feelings and NeedsExceedingAge-AppropriateProgressingAreas of ConcernPlease choice onePlays Alone HappilyExceedingAge-AppropriateProgressingAreas of ConcernPlease choice oneIs Cooperative in Taking DirectionExceedingAge-AppropriateProgressingAreas of ConcernPlease choice oneWillingly Observes Rules and Accepts School ProtocolsExceedingAge-AppropriateProgressingAreas of ConcernPlease choice onePreviousNextACADEMIC DEVELOPMENT Stays On and Complete TaskExceedingAge-AppropriateProgressingAreas of ConcernPlease choice oneDemonstrates Creativity and ImaginationExceedingAge-AppropriateProgressingAreas of ConcernPlease choice oneExhibits Problem Solving AbilitiesExceedingAge-AppropriateProgressingAreas of ConcernPlease choice oneAsks Relevant QuestionsExceedingAge-AppropriateProgressingAreas of ConcernPlease choice oneContributes and Listens AppropriatelyExceedingAge-AppropriateProgressingAreas of ConcernPlease choice oneSeeks Help When Appropriate ExceedingAge-AppropriateProgressingAreas of ConcernPlease choice oneAble to Work Without SupervisionExceedingAge-AppropriateProgressingAreas of ConcernPlease choice oneLanguage Comprehension ExceedingAge-AppropriateProgressingAreas of ConcernPlease choice oneExpressive LanguageExceedingAge-AppropriateProgressingAreas of ConcernPlease choice oneMath ReadinessExceedingAge-AppropriateProgressingAreas of ConcernPlease choice oneIf there is additional information or concerns please share. PreviousNextHave you recommended to the Parents/Guardians that this child be evaluated for special learning and/or behavioral needs? If yes, please comment. 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/Guardians 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 NameFirstLastCell PhoneSchool's NameSchool's AddressAddress Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeWork EmailSchool's PhoneSection DividerThank you! Your perspective is important to us. Submit