Has the applicant ever been (select any that apply): *
Required
If you checked any options in the previous question, please detail Student Name, Name of School, Year, Reason, and contact person
Your answer
Does the applicant have any physical and/or psychological condition(s) that may limit regular school work or participation? (if yes please explain) *
Your answer
Does the applicant have any other health problem(s) that Savannah River Academy should be made aware of? (if yes please explain) *
Your answer
Does the applicant take any medication(s) on a regular basis, during school hours? (If yes, please list the medications, dosages, and times regularly administered. Only medications taken during school hours are needed.) *
Your answer
Has the applicant ever been referred for or received professional, psychological, or education testing or personal counseling? (If yes, please provide the school with a copy of test results or consultation report.) *
Required
Has the applicant ever taken, or is currently taking, any medication(s) for ADD / ADHD? (The existence of ADD/ADHD and/or the taking of medications shall not be the basis for denial of admission to Savannah River Academy.) *
Required
Are you interested in our dyslexia program? *
Required
Parent 1 data: Full Name, Home address, Home Phone, Cell Phone, Place of Employment, Nature of Work / Position, Work Phone, Preferred Email *
Your answer
Parent 2 data: Full Name, Home address, Home Phone, Cell Phone, Place of Employment, Nature of Work / Position, Work Phone, Preferred Email *
Your answer
Parents' marital status *
Living arrangements of applicant *
If parents are divorced, who has legal custody? *
Your answer
Who will be financially responsible? *
Your answer
Please list the names and grades of other children in the family and include name of school(s) currently attending *
Your answer
By typing my name and the date below, I certify that the information contained in this application is true and accurate to the best of my knowledge. I also grant permission for Savannah River Academy to request my child's records. *