Solebury School Learning Support Program Supplemental Application
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Student Name
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First Name
Last Name
Applying for Grade
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9
10
11
12
Boarding or Day?
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Boarding
Day
When was your child first formally evaluated?
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When was the most recent evaluation completed for your child?
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For this most recent evaluation, what tests were given?
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Educational
Psychological
Both
What do you understand to be the current diagnosis?
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When were learning-related problems first suspected?
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Please indicate whether any of the following academic skills were/are especially difficult or relatively easy for your child to learn.
Decoding (phonics)
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Relatively Easy
Moderate
Difficult
Reading Comprehension
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Relatively Easy
Moderate
Difficult
Handwriting
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Relatively Easy
Moderate
Difficult
Spelling
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Relatively Easy
Moderate
Difficult
Written Expression
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Relatively Easy
Moderate
Difficult
Grammar/Mechanics
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Relatively Easy
Moderate
Difficult
Listening Comprehension
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Relatively Easy
Moderate
Difficult
Basic Arithmetic
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Relatively Easy
Moderate
Difficult
Math Computation
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Relatively Easy
Moderate
Difficult
Organization
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Relatively Easy
Moderate
Difficult
Test Taking
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Relatively Easy
Moderate
Difficult
Study Skills
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Relatively Easy
Moderate
Difficult
Other
Please indicate levels of achievement in the following academic subject areas.
Reading/Language Arts
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Weak
Solid
Strong
English
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Weak
Solid
Strong
History/Social Studies
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Weak
Solid
Strong
Science
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Weak
Solid
Strong
Mathematics
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Weak
Solid
Strong
Foreign Language
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Weak
Solid
Strong
Which modifications to, or accommodations within the educational environment (i.e. extended time on tests, use of facilitative or assistive technologies such as audio books) have been implemented?
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What modifications to, or accommodations within the educational environment have proved especially useful and are still in place for your child?
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Please list all current and previous educational interventions (i.e. tutoring) and/or specialized educational programs (i.e. pull-out support, in-class support teacher or aide) or therapies (i.e. organizational coach, academic counseling) that have been implemented for your child.
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Please describe which of the above educational interventions seemed most or least effective?
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In general, what do you regard as your child’s strengths (social, academic, physical, personality, etc)?
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What do you regard as your child’s areas of greatest need?
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How does your child learn best? For example: Would you describe your child as a visual learner, auditory learner, hands-on learner, etc.? Or are there environmental conditions such as classroom considerations, or teacher attributes that significantly influence your child’s learning?
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Please provide any other information you think would help us to understand and work effectively with your child.
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