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 Address *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict 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 Development *ExceedingAge-AppropriateProgressingAreas of ConcernPlease choice oneFine Motor Development *ExceedingAge-AppropriateProgressingAreas of ConcernPlease choice oneSpeech Development/Clarity of Speech *ExceedingAge-AppropriateProgressingAreas of ConcernPlease choice oneIf there is additional information or concerns please share. PreviousNextSOCIAL-EMOTIONAL DEVELOPMENTSensitivity Towards Other's Feelings/Respect for Individual Differences *ExceedingAge-AppropriateProgressingAreas of ConcernPlease choice oneDemonstrates Concern for Others *ExceedingAge-AppropriateProgressingAreas of ConcernPlease choice oneForm Friendships *ExceedingAge-AppropriateProgressingAreas of ConcernPlease choice oneAppropriately Initiates and Responds to Peer Interaction *ExceedingAge-AppropriateProgressingAreas of ConcernPlease choice oneRespects Personal Boundaries *ExceedingAge-AppropriateProgressingAreas of ConcernPlease choice oneRespects Property of Others *ExceedingAge-AppropriateProgressingAreas of ConcernPlease choice oneSeek Positive Relationships with Adults *ExceedingAge-AppropriateProgressingAreas of ConcernPlease choice oneDemonstrate Self-Control *ExceedingAge-AppropriateProgressingAreas of ConcernPlease choice oneAdjusts to Transitions *ExceedingAge-AppropriateProgressingAreas of ConcernPlease choice oneExpress Feelings and Needs *ExceedingAge-AppropriateProgressingAreas of ConcernPlease choice onePlays Alone Happily *ExceedingAge-AppropriateProgressingAreas of ConcernPlease choice oneIs Cooperative in Taking Direction *ExceedingAge-AppropriateProgressingAreas of ConcernPlease choice oneWillingly Observes Rules and Accepts School Protocols *ExceedingAge-AppropriateProgressingAreas of ConcernPlease choice onePreviousNextACADEMIC DEVELOPMENT Stays On and Complete Task *ExceedingAge-AppropriateProgressingAreas of ConcernPlease choice oneDemonstrates Creativity and Imagination *ExceedingAge-AppropriateProgressingAreas of ConcernPlease choice oneExhibits Problem Solving Abilities *ExceedingAge-AppropriateProgressingAreas of ConcernPlease choice oneAsks Relevant Questions *ExceedingAge-AppropriateProgressingAreas of ConcernPlease choice oneContributes and Listens Appropriately *ExceedingAge-AppropriateProgressingAreas of ConcernPlease choice oneSeeks Help When Appropriate *ExceedingAge-AppropriateProgressingAreas of ConcernPlease choice oneAble to Work Without Supervision *ExceedingAge-AppropriateProgressingAreas of ConcernPlease choice oneLanguage Comprehension *ExceedingAge-AppropriateProgressingAreas of ConcernPlease choice oneExpressive Language *ExceedingAge-AppropriateProgressingAreas of ConcernPlease choice oneMath Readiness *ExceedingAge-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 Name *FirstLastCell Phone *School's Name *School's Address *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict 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