*
Required
ISK Student Support Parent Questionnaire
ISK is an inclusive school that strives to meet the needs of diverse learners. ISK makes every effort to ensure resources and teaching matches our students’ learning needs. In order to know your child better, please provide us with additional information that will help our team during the application process and in the future should your child join our learning community.
Today's Date
*
required
(dd/mm/yyyy)
Applicant Name
*
required
Date of Birth
*
required
(dd/mm/yyyy)
Proposed Entry
*
required
(dd/mm/yyyy)
Proposed Entry Grade
*
required
Please Select…
Kindergarten
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Grade 6
Grade 7
Grade 8
Grade 9
Grade 10
Grade 11
Grade 12
Your Name (parent)
*
required
Has your child received a medical or psycho-educational diagnosis of any kind? *
Yes
No
If yes, please explain:
Please identify if your child has an identified need in any of the following areas.
Speech/Language Therapy*
Yes
No
Name and Email address of current or last support person
Reason for Support
Start Date
(dd/mm/yyyy)
End Date
(dd/mm/yyyy)
Occupational Therapy*
Yes
No
Name and Email address of current or last support person
Reason for Support
Start Date
(dd/mm/yyyy)
End Date
(dd/mm/yyyy)
Physical Therapy*
Yes
No
Name and Email address of current or last support person
Reason for Support
Start Date
(dd/mm/yyyy)
End Date
(dd/mm/yyyy)
Counseling or Psychological Therapy*
Yes
No
Name and Email address of current or last support person
Reason for Support
Start Date
(dd/mm/yyyy)
End Date
(dd/mm/yyyy)
Learning Support and/or Individualized Education Plan (IEP)*
Yes
No
Name and Email address of current or last support person
Reason for Support
Start Date
(dd/mm/yyyy)
End Date
(dd/mm/yyyy)
One-on-one Classroom Support or Intervention*
Yes
No
Name and Email address of current or last support person
Reason for Support
Start Date
(dd/mm/yyyy)
End Date
(dd/mm/yyyy)
Social Emotional Skill Intervention*
Yes
No
Name and Email address of current or last support person
Reason for Support
Start Date
(dd/mm/yyyy)
End Date
(dd/mm/yyyy)
On-going Medical Support*
Yes
No
Name and Email address of current or last support person
Reason for Support
Start Date
(dd/mm/yyyy)
End Date
(dd/mm/yyyy)
Medications
Is your child currently taking any medications? *
Yes
No
If yes, please complete the section below:
Medication Name
Reason for use
Dose
When did your child begin taking this medication?
(dd/mm/yyyy)
Medication Name
Reason for use
Dose
When did your child begin taking this medication?
(dd/mm/yyyy)
Medication Name
Reason for use
Dose
When did your child begin taking this medication?
(dd/mm/yyyy)
Medication Name
Reason for use
Dose
When did your child begin taking this medication?
(dd/mm/yyyy)
Closing Questions
What do you consider your child’s greatest strengths?
*
required
What are you hoping to find in your child’s new school?
*
required
Please send a confirmation email to the address below*:
Please provide an email address where we can send a link to your current form.
Email Address :