Gateway Charter School Supplemental Application 2023-2024

Please complete the form below. Required fields marked with an asterisk *

Name of Applicant*

Student's Name

Answer Required

Student's Home Address

Street Address*

Answer Required

City*

Answer Required

Zip/Postal*

Answer Required

Applying for Grade*

Answer Required

Kindergarten

Present Grade*

Answer Required

Pre-K

Present School*

Answer Required

Present District*

Answer Required

Appoquinimink

Brandywine

Christina

Colonial

Red Clay

Other:

Parent/Guardian Contact Information

First Name

Answer Required

Middle Name

Answer Required

Last Name

Answer Required

Mobile Phone

Number Required

Home Phone

Number Required

Work Phone

Number Required

Parent/Guardian 2 Contact Information

First Name

Answer Required

Middle Name

Answer Required

Last Name

Answer Required

Mobile Phone

Number Required

Home Phone

Number Required

Work Phone

Number Required

How did you hear about Gateway Charter School?*

Answer Required

FAMILY INFORMATION

Will the student have brothers or sister applying to Gateway Charter School this year? If yes, provide student name and grade. (A separate application must be received for each student).*

Student Name and Grade

Answer Required

The following information will not be used for selection purposes. It will assist GLS in preparing a proper instructional plan for each student

HEALTH INFORMATION

Please list any special health issues, including allergies

Answer Required

Name of child's pediatrician

Answer Required

Date of last physical exam

Answer Required

Date eyes last examined

Answer Required

Hearing difficulties?

Answer Required

Yes

SCHOOL HISTORY (Previous schools your child has attended.)

School*

Answer Required

Grades Attended*

Answer Required

School

Answer Required

Grades attended

Answer Required

School

Answer Required

Grades attended

Answer Required

What are your child's strengths?

Answer Required

What has your child liked most in school?

Answer Required

What has your child liked least about school?

Answer Required

Has your child ever been suspended or expelled from school?*

Answer Required

Yes

If yes, please describe

Answer Required

Does your child have an Individual Education Plan (IEP)? *

Answer Required

Yes

EDUCATIONAL HISTORY

Is your child currently receiving speech/language therapy?*

Answer Required

Yes

Is you child currently receiving occupational therapy?*

Answer Required

Yes

Please list your child's favorite activities, hobbies and games, including sports

Answer Required

Does you child play a musical instrument?

Answer Required

Yes

Does your child have difficulty in establishing and maintaining relationships?*

Answer Required

Yes

If yes, please describe

Answer Required

Please describe any concerns you may have about your child's social, emotional, or behavioral functioning.

Answer Required

Please state briefly why you think Gateway Charter School might be a good school for your child.

Answer Required

Application completed and signed by

Contact Information

Parent/Guardian

Answer Required

Date

Answer Required

Final acceptance for admission will not occur until the school receives copies of the most recent school reports, assessments and evaluations you have listed in the application. It is the parents' responsibility to secure copies of all reports and forward them to Gateway Charter School. In addition, a mandatory interview with the parent(s) and student is required prior to acceptance. Interviews will be scheduled only after a completed supplemental applicaion is received with all of the required documents.

Gateway Charter School programs and policies are applied with equal consideration to all of its applicants and students. All informaiton in this application and related documents will be held in the strictest confidence.

Please fix the highlighted areas below before submitting.

Gateway Charter School Supplemental Application 2023-2024