APPLICATION FOR ADMISSION

Student Accepted/Letter Sent
Transportation
STUDENT INFORMATION
Race:
Ethnicity:
FAMILY INFORMATION
Parents are:
Student Lives With:

*SSN of the parent or guardian who applied for the scholarship is mandatory for students receiving McKay Scholarships

STUDENT NEEDS

In order to determine what resources may be needed to best serve your child, please answer the questions below:

Does your student have an IEP?
Does your student have a 504 Plan?
Does your child currently require any of the following therapies or interventions?
Speech and Language Therapy
Social Skills :
Academic Tutoring :
Psychotherapy / Counseling / Family Therapy :
Occupational Therapy or Physical Therapy :
Please indicate areas of concern/difficulty:
Reading :
Math:
Written language:
Comprehension:
Attention:
Following Directions:
Motor Skills:
Sensory Processing:
Behavior:
Speech Impairment :
Vison Impairment :
Hearing Impairment :
Social Interaction :
Other Disability :
ADMISSIONS INFORMATION

A non-refundable application fee of $25 must accompany this form.

In order to complete the enrollment process, the following must be submitted prior to the start of school:

  • Florida School Entry Medical Exam Form – Only for students entering a Florida school for the first time
  • Immunization Record
  • Health Information and Contact Authorization Form
  • Esther’s School Release Form
  • Copy of parent ID
  • Copy of student Birth Certificate and SS Card
  • Scholarship Documentation
  1. McKay – Parent Affidavit (MUST be completed by the parent listed on the McKay scholarship application)
  2. Gardiner Scholarship (Step Up or AAA) – Award Letter and ID Card
  3. FTC/Income Based Scholarship (Step Up or AAA) – Award Letter

PARENT AGREEMENT

  • I understand that any and all information that I have provided is strictly confidential and is to be used only by the school to serve the best interests of my child.
  • I agree to pay my financial obligations in accordance with the financial agreement policy set forth by the school. I understand that if I do not meet my financial obligations, my student will be withdrawn from Esther’s School. This includes failure to be awarded an expected scholarship or loss of the student’s scholarship.
  • I agree to complete all steps required to ensure proper distribution of my student’s scholarship award (if applicable) in a timely manner.
  • I give permission for my child to take part in all school activities, including outdoor activities and school-sponsored trips away from the school premises. I absolve Esther’s School and its staff from any liability that may result from my child participating in or attending these activities that is not the result of gross negligence.
  • I agree to work cooperatively with school staff and adhere to all the policies outlined in the Esther’s School student handbook.
  • To the best of my knowledge, all statements and information that I made on this application are complete and true.