STEM Hybrid Program
Interest Application
Please complete this application as accurately as possible. If your child is accepted into the STEM Homeschool Program, an email will be sent by July 1, 2024 with the information to register. Registration and deposit must be completed by August 1, 2024. Thank you for your interest.
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Child's First Name *
Child's Last Name *
Child's Birthdate *
MM
/
DD
/
YYYY
Parent's First Name *
Parent's Last Name *
Parent's Email Address *
Parent Phone Number *
Please assess your child's academic ability *
Not Yet
Emergent
Developing
Proficient
Reading
Math
Writing
Does your child have any food sensitivities? *
Does your child participate in the STEP UP Scholarship program? *
If yes, please describe your child's food sensitivities?
Does your child participate well in group activities? If no, please explain: *
If no, please explain:
Can your child attend to a task for more than 30 mins? *
If you selected 'Sometimes' what is the best way for our staff to motivate your child to accomplish the task?
Are there any behaviors that we should be aware of? *
If you replied Yes above, please describe behaviors. (when these behaviors typically occur, what they look like, how long they last, what you typically do to calm the situation, describe any behavior triggers (e.g. loud noises, being touched):
Does your child communicate with others effectively without accommodations (e.g. Verbal, Non-Verbal, Sign Language, Communication device, etc.) *
If no, please describe.
Does your child have a disability? *
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