• Chelsea School Application For Admission

  • Student Information

    PLEASE FILL OUT ALL SECTIONS COMPLETELY

  •  -  - Pick a Date
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  • Parent/Guardian Information

    PLEASE FILL OUT THIS SECTION COMPLETELY. 

  • Parent/Guardian Information

    PLEASE FILL OUT THIS SECTION COMPLETELY. PLACE A CHECK IN THE BOX NEXT TO THE BEST METHOD OF CONTACT

  • Who else resides in the home with the student?


  • Please complete the educational history chart:

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  •  -  - Pick a Date
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  •  -  - Pick a Date
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  • Please list the names and phone numbers of professionals (teachers, tutors, psychiatrists, 

    psychologists, etc.) who are presently working with your child.

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  •   No Difficulty Some Difficulty Great Difficulty
    Getting started on tasks
    Following oral instructions
    Following written instructions
    Keeping track of materials
    Staying on task
    Completing work on time
    Reading text materials
    Spelling
    Writing legibly
    Computing math problems
    Understanding math concepts
    Interacting positively with peers
    Following class rules
    Working well in a small group
    Participating in class discussion



  • Total:   $ 0.00
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