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Door Prairie Adventist School |  |
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 Application
ADMISSIONS AND APPLICATION PACKET
THE MISSION
The mission of Door Prairie Adventist School is to follow in the footsteps of Jesus Christ in developing the mind, body, and soul to achieve the divine purpose of His creation through study, service, and leadership.
ADMISSIONS CRITERIA
• Dedication to academic performance, as evidenced by previous
grades, standardized test scores, admissions screening and
teacher evaluations
• Responsible behavior and self-discipline, as attested by teacher
and principal documentation
• Dedication and desire to live a Christian life.
ADMISSIONS RESPONSIBILITY
Admission to Door Prairie Adventist School is based on the student’s ability to satisfy admissions criteria. The school maintains the right to deny admission to any student who does not satisfy the stated criteria. In order to enter first grade, a child must be six years old on or before July 1. A Pre-K student must be four years old and a Kindergarten student must be five years old on or before July 1. Ages must be verified by an official birth certificate.
ADMISSIONS CHECKLIST
APPLICATION FOR ADMISSION/PARENTPERSPECTIVE - The parent or guardian should complete the Application for Admission and the Parent Perspective forms and return to the school’s Admissions Office with the non-refundable application fee of $50.00 per student.
AUTHORIZATION TO RELEASE INFORMATION - The parent or guardian should complete the top portion of the Transcript and Record Release form and submit it to his or her child’s current school authorizing the school to forward a copy of completed transcripts for the past three school years to Door Prairie Adventist School’s Admissions Office.
TEACHER AND SCHOOLADMINISTRATOR QUESTIONNAIRES - The parent or guardian should give the Confidential Questionnaire forms to his or her child’s current teacher and school administrator to be returned directly to Door Prairie Adventist School’s Admissions Office.
SURVEYOF SPECIAL NEEDS - The parent or guardian should complete this form and forward it and any diagnostic testing results to the Admissions Office.
BIRTH CERTIFICATE AND IMMUNIZATIONS - The parent or guardian should provide a copy of the applicant’s official birth certificate and immunization records to Door Prairie Adventist School’s Admissions Office. These must be provided before the application will be submitted to the admissions committee.
ADMISSIONS SCREENING - Each applicant applying for admission is required to take the entrance exams designed for that particular grade level. A shadow visit is required for all students applying to grades one through eight. A play session is required for Pre-K and K. Parents will be notified by the Admissions Office as to the time of the testing and shadow or play dates. An interview is required for all Middle School applicants.
FINANCIAL AID
The School Board is committed to allocating a portion of the operating budget to aid students who adequately demonstrate that they will have difficulty paying the full tuition. Financial aid will be in the form of partial tuition. Door Prairie Adventist School complies with all applicable State and Federal laws on discrimination. If interested, please request a financial aid application.
APPLICATION FOR ADMISSION
Date
Has applicant previously applied to Door Prairie Adventist School? ____ Yes ____ No
Grade Applying For
Student
Last First Middle Preferred
Parent/Guardian
Last First Middle
Home Address
Number Street
City State Zip Code
Parent/Guardian Telephone Numbers
Home ( ) Business ( )
Cell ( )
Please be sure to call the school office if your address or telephone number changes.
Student’s Date of Birth Gender
Year/Month/Day M or F
Parent/Guardian Signature
Father’s Name
Last First Middle
Address
Number Street City State Zip Code
Telephone Numbers
Home ( ) Business ( )
Cell ( ) Email
Occupation Employer
Mother’s Name
Last First Middle
Address
Number Street City State Zip Code
Telephone Numbers
Home ( ) Business ( )
Cell ( ) Email
Occupation Employer
(Application for Admission Continued)
Applicant Resides with (check one):
Both father and mother Father only Mother only Guardian
Family’s Religious Affiliation
Church Membership
Please state your reasons for wishing to enroll your child in Door Prairie Adventist School.
How did you learn about Door Prairie Adventist School?
List all children in the family in order of birth.
PARENT PERSPECTIVE FORM
FATHER/GUARDIAN OF APPLICANT
Please provide us with your perspective on your child. Describe your child’s strengths and abilities, special areas of interest or concerns. We appreciate your effort in trying to help us know your child better.
Comments
Father/Guardian Signature Date
MOTHER/GUARDIAN OF APPLICANT
Please provide us with your perspective on your child. Describe your child’s strengths and abilities, special areas of interest or concerns. We appreciate your effort in trying to help us know your child better.
Comments
Mother/Guardian Signature Date
Applicant (please check all that apply)
____ has diagnosed learning disability
____ has diagnosed behavior disorder
___ _ requires regular school-administered medicine
CONFIDENTIAL TEACHER QUESTIONNAIRE
(NOT APPLICABLE FOR STUDENTS APPLYING FOR PRE-K or K)
To be completed by Current Homeroom Teacher or Core Subject Teacher in Middle School Grades
Instructions to Parent or Guardian.
Please complete items 1–4 and give to your child’s current teacher. He/She should return the questionnaire directly to Door Prairie Adventist School in a sealed envelope.
1. Applicant’s Name 2. Current Grade
My son/daughter is applying for admission to Door Prairie Adventist School. Please complete this form and return it directly to Door Prairie Adventist School’s Admissions Office. I hereby authorize the release of my child’s records and evaluative data to Door Prairie Adventist School and agree to hold the school and administrator below harmless for information provided in this questionnaire.
3. Date 4. Parent/Guardian Signature
School Teacher Grade/Subject
Your candid evaluation of the student will be of invaluable assistance to the school’s Admissions Committee. Please use the back of this form for any additional comments. All information provided will be held in strict confidence and will only be disclosed to members of the school’s Admissions Committee.
Are students in your class grouped by ability?
If yes, in what subject(s) and on what level is the student performing?
Comments
Signature Date
CONFIDENTIAL
SCHOOL ADMINISTRATOR QUESTIONNAIRE
(NOT APPLICABLE FOR STUDENTS APPLYING FOR PRE-K or K)
Instructions to Parent or Guardian.
Please complete items 1–4 and give to your child’s current administrator. He/She should return the questionnaire directly to Door Prairie Adventist School in a sealed envelope.
1. Applicant’s Name 2. Current Grade
My son/daughter is applying for admission to Door Prairie Adventist School. Please complete this form and return it directly to Door Prairie Adventist School’s Admissions Office. I hereby authorize the release of my child’s records and evaluative data to Door Prairie Adventist School and agree to hold the school and administrator below harmless for information provided in this questionnaire.
3. Date 4. Parent/Guardian Signature
School Name Administrator Name
Your candid evaluation of the student will be of invaluable assistance to the school’s Admissions Committee. Please use the back of this form for any additional comments. All information provided will be held in strict confidence and will only be disclosed to members of the school’s Admissions Committee.
Length of time acquainted with student
Is this student eligible to return to your school?
Please share the student’s observable strengths and limitations.
Does the student exhibit behavioral or other concerns that might affect school performance?
Comments
Signature Date
SURVEY OF SPECIAL NEEDS
At our school we believe we are in a partnership with parent(s) or guardian(s), to provide the best education for children. Any information that assists us in this task ultimately benefits your son or daughter. The following information is requested to ensure that each student’s individual learning needs are met to the best of our ability. Failure to provide this information may inhibit the faculty’s ability to meet the individual needs of your child, and consequently, the school reserves the right to forego acceptance or continuation of the child in our school if such information is not provided. PLEASE INCLUDE ANY DIAGNOSTIC TESTING SO DOOR PRAIRIE ADVENTIST SCHOOL CAN EVALUATE YOUR CHILD’S NEEDS. PLEASE NOTE THAT ALL INFORMATION IS HELD IN THE STRICTEST CONFIDENCE.
1. Has your child been tested for any special concerns—academic, behavioral or other?
Yes No If yes, please explain.
2. Has your child been on medication for education/behavioral purposes?
Yes No If yes, please explain.
3. Has your child ever been referred for special educational services?
Yes No If so, what type, by whom and with what results.
4. Has your child had special educational services provided? Yes No
If yes, please explain.
5. Has your child ever been under the care of a professional counselor, psychologist or psychiatrist? Yes No
If yes, please explain.
6. Are you willing to share all previous and future special education information/tests with Door Prairie Adventist School? Yes No
7. Are you willing to sign a release to allow the Principal and/or Teacher to speak with the person(s) who conducted any of these services or tests or prepared any information?
Yes No
Parent/Guardian Signature Date ________________________Additional links on this topic:
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