Application

PRINT and FILL out application

CLICK TO DOWNLOAD

Your complete application should include a copy of a recent IEP and assessment (if you have them).

Please SCAN and EMAIL completed application and supporting documents to ecrasnow@stem3academy.org

OR

FILL out and SUBMIT form below along with supporting documents (if you have them).

STEM Campus

 

ADMISSIONS APPLICATION

    STUDENT INFORMATION

  • PARENT INFORMATION

  • PARENT WORK INFORMATION

  • FAMILY HISTORY

  • MEDICAL

  • SCHOOL HISTORY

  • SCHOOL LIST Please list all schools in which your child was placed prior to his/her current school. Also indicate if it was a special education program and the reason for discontinuation.

  • HISTORY OF INTERVENTIONS

  • IEP INFORMATION AND FUNDING SOURCE - Please be able to provide a copy of your child’s two most recent annual IEPs, and all subsequent addenda. If your child does not have a current IEP, please state where you are in the IEP process. Do you currently have:

  • REFERREAL SOURCE

 

Verification

For help or more information contact Tamika DeCambra at 818-623-6386