Remote Learning

The Phoenix School Remote Learning Survey

Basic Information
Name of child*
First Last
Child's preferred name*
Date of Birth*
MM
DD
YYYY
Current age*
Current grade*
Home address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Present school*
Grade applying for:*
Parent/Guardian Contact Information
Parent/Guardian #1 name*
First Last
Additional Household
- Yes
- No
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Preffered Phone*
Email*
Additional Parent/Guardian
Parent/Guardian #2 name
First Last
Same as student
- Yes
- No
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Preferred phone
Email
Additional Information
Please list all siblings Name, Age, and Present School (one per line)*
Please list Names and Your Relationship with any relatives or friends that attend or previously attended The Phoenix School
How did you learn about The Phoenix School?*
Describe your interest in The Phoenix School remote learning and why you are seeking this for your child.*
Are you interested in full time, part time, or something else?*
- Full Time - 8:00am-3:00pm
- Part Time - 8:00am-11:30pm
- Other - Please Explain
Please explain what other options you would like for The Phoenix School Remote Learning.
Please describe your child’s personality and learning style.*
What do you see as your child’s particular strengths, talents, and challenges?*
Please list your child’s special interests (music, art, sports, drama, dance, computers, etc).
Has your child received any support services or therapy for any facet of his or her development?*
- Yes
- No
Please explain:
Please share with us any thoughts or concerns about your child that might further our understanding them.*

Remote Learning

The Phoenix School Remote Learning Survey

Basic Information

Parent/Guardian Contact Information

Additional Parent/Guardian

Additional Information

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