Westlawn Application for Admission
We are pleased that you are interested in Westlawn School for your child. Please make sure to have carefully read over the admissions criteria and process. If you have questions, please contact us at 336-937-6088.
Admissions Information
Westlawn School maintains a policy of limited enrollment and selective admissions recognizing that there is a range of students that the school serves best. The goal of the admissions process is to determine if the child’s needs will be served most appropriately by attending Westlawn School.
Application Fee
Nonrefundable Application Fee: $200. You will receive an invoice upon application submission.
Your Name:
First Name
Last Name
Your Email:
example@example.com
Today's Date
-
Month
-
Day
Year
Date
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Student Information
Student's Full Name (First, Middle, Last)
Student's Preferred Name:
Student's Date of Birth:
-
Month
-
Day
Year
Date
Student's Current Age
Student's Gender:
Male
Female
Nonbinary
Student's Pronouns:
He/Him
She/Her
They/Them
Student lives with:
Both Parents
Mother
Father
Other
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Parent/Guardian 1 Information:
Please complete the following questions for Parent/Guardian 1
Parent/Guardian 1 Full Name (First, Middle, Last):
Parent/Guardian 1 Phone Number:
Please enter a valid phone number.
Parent/Guardian 1 Email:
example@example.com
Parent 1 Employer
Years there
Parent/Guardian 1 Address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Parent/Guardian 2 Information:
Please complete the following questions for Parent/Guardian 2
Parent/Guardian 2 Full Name (First, Middle, Last):
Parent/Guardian 2 Phone Number:
Please enter a valid phone number.
Parent/Guardian 2 Email:
example@example.com
Parent 2 Employer
Years there
Parent/Guardian 2 Address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Student History
Name and location of last school attended:
Grades attended:
Explain why you are looking into another school:
Where did your child complete their last psycho/educational evaluation?
Date of last psycho/educational evaluation:
-
Month
-
Day
Year
Date
Documentation of IQ must accompany this application. Please indicate your preferred means of documentation:
Psych Evaluation from School
Cognitive/Aptitude/IQ testing from Independent Evaluator
My child does not have this documentation at this time.
Other
Please indicate the diagnoses/indentifications
Upload documents related to Psych Evaluations:
Browse Files
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Choose a file
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of
Is your child currently taking medication on a regular basis (please specify):
Does your child receive any specialized services through his/her/their current school?
IEP
Section 504 Plan
Learning Support
Behavior Support
None
Other
Please describe those services:
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Behavior
Student's special interests, activities, honors:
Please identify any behavioral issues which will help us with working with your child in the classroom:
Has your child ever demonstrated any of the following behaviors from (infancy to current):
defies adult requests
temper
arguments
resentful
blames others
swearing
fidgets
distracted
difficulty following directions
unable to stay on task
trouble remaining seated
irritable mood
sleep/appetite disturbance
suicidal ideation
depressed mood
feelings of worthlessness
fatigue
mood disturbance
manic behavior
hypo manic behavior
depressive symptoms
physical/somatic symptoms
worrisome
fearful
obsessive
compulsive
recurrent dreams/flashbacks of traumatic event
Runaway/Elopement
Has your child ever been suspended, dismissed, asked to leave for academic, disciplinary, or other reasons? (If yes, please specify)
What do you perceive to be your child's strengths, abilities, talents?
What do you perceive to be your child's weaknesses or vulnerabilities?
Describe the student's home life and living situation:
How does your child get along with his/her/their family members (parents, siblings, extended family):
How does your child get along with his/her/their peers?
How does your child interact with teachers, adults, and/or authority figures?
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Student Questionnaire
Please take a moment to complete this questionnaire in your own words so we can learn about you.
Your Preferred Name
*
First Name
Last Name
What is your favorite thing about school?
*
Tell us what you do not like about school.
*
Tell us about your best day ever.
*
Tell us about your favorite thing to do outside of school.
*
What is your favorite book or movie and why?
*
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Additional Information
How did you learn about Westlawn school?
By signing this document, I affirm that all of the information and answers to questions herein are complete, true, and accurate to the best of my knowledge. I understand that any misrepresentation, falsification, or omission of any facts called for in the application may render this application void and result in loss of fees, tuition, and consideration or placement at Westlawn School.
*
Submit
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