Application for Admission
Please send or email your completed application to:
Chicago Friends School
1246 W. Thorndale Ave.
Chicago, IL 60660
773-442-2371
ChicagoFriendsSchool.org
[email protected]
Please include your $75 application fee via check or via the PayPal link found on the Donations
page on our website: http://chicagofriendsschool.org/donate/
Student and Family Information
Name
Date of Birth
Sex
Application for Grade
Home Address
City, State
Zip Code
1 Parent/Guardian 1 Name
Relationship
Home Address
City, State
Zip Code
Home Phone
Work Phone
Cell Phone
Email
Name of Employer
Profession
Parent/Guardian 2 Name
Relationship
Home Address
City, State
Zip Code
Home Phone
Work Phone
Cell Phone
Email
Name of Employer
Profession
Who is the child’s legal guardian? __________________________________________________
Communication from the school should be sent to: _____________________________________
Who is financially responsible for the tuition? ________________________________________
2 What is the primary language of family members if other than English? ____________________
What language does the child speak at home if other than English? ________________________
Siblings:
Name
Age
School
Name
Age
School
Name
Age
School
School Information
Previous and Current Schools Attended:
School 1 Name and Address
Telephone or Email
Grades Completed
Years Attended
School 2 Name and Address
Telephone or Email
Grades Completed
Years Attended
School 3 Name and Address
Telephone or Email
Grades Completed
Years Attended
Has the applicant been suspended, withdrawn, or expelled from a previous school or preschool?
Yes___
No ____
If yes, please explain:
3 Medical Information
Are there any medical or health-related issues, such as allergies or other health problems, of
which we should be aware?
Yes___
No____
If yes, please explain.
Is your child presently under medical treatment of which the school should be aware?
Yes____
No____
If yes, please explain.
Has your child ever had a psychological or psychiatric evaluation or received treatment?
Yes____
No____
If yes, please explain. (We may request additional documentation.)
Has your child ever been tested or evaluated to assess learning or developmental needs?
Yes____
No____
If yes, please explain. (We may request additional documentation.)
Is there any reason why your child might not be able to fully participate in all school activities?
Yes____
No____
If yes, please explain.
4 Parent/Guardian Comments
What are the first three words that come to mind to describe your child?
1. _______________________
2. _______________________ 3._______________________
What school experience do you want for your child?
What advice would you offer to someone working with your child?
Please tell us about your child’s development, including physical, social, emotional, cognitive,
and academic. What strengths, needs, and challenges do you see?
What are some of your child’s interests (play activities, topics, extracurricular, etc.):
Why do you think Chicago Friends School would be a good match for your child and your
family?
How do you see you/your family being involved in your child’s education and school?
If you would like to provide additional information regarding your child, please attach additional
comments and/or documents.
5 Agreement
As part of this application to Chicago Friends School, the applicant and his or her parent(s)/guardian(s) agree to the following:
1. As part of my/our child's application for admission, I/we grant Chicago Friends School permission to request, receive, and
discuss with school personnel information regarding the confidential teacher questionnaire, school reports, and additional testing
documentation.
2. I/We understand that all information regarding a candidate's application for admission to Chicago Friends School will be
treated with complete confidentiality. Only authorized Chicago Friends School personnel have access to this information, and
then only to the extent that the information is relevant to Chicago Friends School admission and placement decisions.
Information received within the scope of this policy is not disclosed to the applicant nor to the applicant's family.
3. I/We understand that all admissions information is confidential and will be held securely for five years and then destroyed if
my/our child is not admitted.
4. I/We have read and understand this application. I/we state that the information submitted is complete and accurate to the best
of my/our knowledge and belief. Further, I/we understand that Chicago Friends School reserves the right to modify or cancel any
program or part thereof.
The $75 application fee is enclosed or was submitted electronically. I/we understand that this fee is nonrefundable.
Signature of parent(s)/guardian(s)
Date
Signature of parent(s)/guardian(s)
Date
Nondiscrimination Statement at Chicago Friends School
Chicago Friends School is committed to creating an environment in which diversity is a fundamental value. We believe that
diversity enhances the quality of Chicago Friends School and enriches understanding among students, employees, and the entire
community. Chicago Friends School expects all of its students and employees to join together to foster a community where
everyone values individual and group differences, respects the perspectives of others, and communicates openly to attain the best
education.
Chicago Friends School admits students of any race, color, creed, religion, national and ethnic origin, immigration status, sexual
orientation, gender identity, or sex to all the rights, privileges, programs, and activities generally accorded or made available to
students at the school. It does not discriminate on the basis of race, color, creed, religion, national and ethnic origin, immigration
status, sexual orientation, gender identity, or sex in administration of its educational policies, admissions policies, scholarship and
loan programs, and athletic and other school-administered programs.
Chicago Friends School provides equal opportunity for all employees and applicants for employment regardless of race, color,
creed, religion, national and ethnic origin, immigration status, sexual orientation, gender identity, or sex, except where sex or age
is a bona fide occupational qualification.
The following identifiers and information is OPTIONAL:
This information is requested to help us complete state and federal surveys. Disclosure of this information is purely voluntary. It
will be kept strictly confidential and will not affect the consideration of this application in any way. Please check as many
identifiers that you consider most appropriate for the applicant and you family:
____African American/Black
____Asian/Asian American
____European American/White/Caucasian
____Latino(a)/Hispanic American
____Middle Eastern American
____Native American
____Pacific Islander American
____Multiracial/other (please describe:
_________________)
Thank you for your interest in Chicago Friends School.
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