Family and Student Questionnaire Family and Student Questionnaire If you don’t want to submit the form online you can click the link below to download the file and submit to our school. Family and Student Questionnaire Family and Student QuestionnaireParent/Guardian*Telephone*Email* Add Remove Child's name*Grade*Preschool 3Preschool 4KindergartenGrade 1Grade 2Grade 3Grade 4Grade 5Grade 61. Please describe your relationship to the Lord Jesus Christ (parent 1).*1. Please describe your relationship to the Lord Jesus Christ (parent2 ).2. Are both parents in agreement on enrollment?* Yes No3. Are you a member of any church?* Yes No4. Please explain your reasons for choosing CRCS as the educational choice for your student.*5. What is your perspective concerning the school’s responsibility in disciplining and guiding your child?*6. Will your child have any difficulty communicating in English?* Yes No7. Has your child ever been referred for a developmental or academic evaluation?* Yes NoIf YES to question #7, please provide details below8. Has your child been sent to a principal, director, or guidance counselor for previous disciplinary problems?* Yes No9. Why did you withdraw your child from your last school?*Please fill out the “Permission to Release Information” form in the Registration Packet.QUESTIONS 10 - 14 (KINDERGARTEN - 6TH GRADE ONLY)10. Has your child ever been suspended, dismissed, or denied reenrollment from an educational or extended care program for academic, disciplinary, or other reasons?* Yes No11. Has your child experienced any of the following academic accommodations?Tutoring* Yes NoModification of grading scale* Yes NoModification of work load* Yes NoSpecial classroom accommodations (oral testing, extended time)* Yes No12. Does your child have a history of:ADD, ADHD (copy of diagnosis by a licensed psychologist or physician must accompany application)* Yes NoLearning Disability (copy of testing and Individual Education Plan must accompany application)* Yes NoPhysical Disability (copy of Individual Education Plan must accompany application)* Yes NoOther, please indicate*13. Has your child ever repeated a grade level?* Yes NoIf yes, which grade and for what reasons.*14. Has your child received a physical, visual, and hearing examination in the last year?* Yes NoIf so, please give results.*Students with academic difficulties applying for admission to Calvary Road Christian School must supply all confidential records, present school records, and any educational evaluations before the admissions process can proceed. I acknowledge that I have accurately completed the Family and Student Questionnaire and have supplied all records, evaluations, IEP’s and other information if applicable. I understand that by omitting any information, or falsifying of documents, I am jeopardizing my child’s acceptance or continued enrollment.* I agree to the terms and conditions mentioned above.Note: please click SUBMIT before proceeding to the next sectionIf you are human, leave this field blank.