Admissions - Grand View Christian School

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New Student Visit Form

1. How did you find out about GVCS? *
GVCS Gala Friend/Family Social Media/ Website Online Search Church News Media Sporting/Fine Arts Event Other
2. Names of Parents/Guardians *
3. Phone Number: *
4. Address: *
Address 1
Address 2

City

State

Zip
5. Relationship to Student: *
Guardian Grandparent Parent Other (please note below)
6. If other, please list here:
7. Church: *
8. Student #1 Name: *
9. Student #1 Current School: *
10. Student #1 Current Grade: *
Preschool Kindergarten 1st 2nd 3rd 4th 5th 6th 7th 8th 9th 10th 11th 12th
11. Does Student #1 have a current IEP of 504 plan? *
Yes No
12. Has student #1 been on an IEP or 504 plan in the past? *
Yes No
13. Does student #1 participate in an (ESL) English Second Language program? *
Yes No
14. Has student #1 been diagnosed with any social/emotional disorders? *
Yes (please select below) No
15. If yes, please choose one. If no, disregard:
Anxiety Autism Depression Other
16. If yes, please explain. If no, disregard:
17. Has student #1 ever been suspended or expelled from school? *
Yes (if selected, please explain below) No
18. If yes, please explain. If no, disregard:
If no other students, please skip to question #52.
19. Student #2 Name (if applicable):
20. Student #2 Current School:
21. Student #2 Current Grade:
Preschool Kindergarten 1st 2nd 3rd 4th 5th 6th 7th 8th 9th 10th 11th 12th
22. Does Student #2 have a current IEP of 504 plan?
Yes No
23. Has student #2 been on an IEP or 504 plan in the past?
Yes No
24. Does student #2 participate in an (ESL) English Second Language program?
Yes No
25. Has student #2 been diagnosed with any social/emotional disorders?
Yes (please select below) No
26. If yes, please choose one. If no, disregard:
Anxiety Autism Depression Other
27. If yes, please explain. If no, disregard:
28. Has student #2 ever been suspended or expelled from school?
Yes (if selected, please explain below) No
29. If yes, please explain. If no, disregard:
30. Student #3 Name (if applicable):
31. Student #3 Current School:
32. Student #3 Current Grade:
Preschool/Kindergarten Transition Kindergarten 1st 2nd 3rd 4th 5th 6th 7th 8th 9th 10th 11th 12th
33. Does Student #3 have a current IEP of 504 plan?
Yes No
34. Has student #3 been on an IEP or 504 plan in the past?
Yes No
35. Does student #3 participate in an (ESL) English Second Language program?
Yes No
36. Has student #3 been diagnosed with any social/emotional disorders?
Yes (please select below) No
37. If yes, please choose one. If no, disregard:
Anxiety Autism Depression Other
38. If yes, please explain. If no, disregard:
39. Has student #3 ever been suspended or expelled from school?
Yes (if selected, please explain below) No
40. If yes, please explain. If no, disregard:
41. Student #4 Name (if applicable):
42. Student #4 Current School:
43. Student #4 Current Grade:
Preschool/Kindergarten Transition Kindergarten 1st 2nd 3rd 4th 5th 6th 7th 8th 9th 10th 11th 12th
44. Does student #4 have a current IEP or 504 plan?
Yes No
45. Has student #4 been on an IEP or 504 plan in the past?
Yes No
46. Does student #4 participate in an (ESL) English Second Language program?
Yes No
47. Has student #4 been diagnosed with any social/emotional disorders?
Yes (please select below) No
48. If yes, please choose one. If no, disregard:
Anxiety Autism Depression Other
49. If yes, please explain. If no, disregard:
50. Has student #4 ever been suspended or expelled from school?
Yes (if selected, please explain below) No
51. If yes, please explain. If no, disregard:
52. Why are you interested in GVCS?
53. Which school would you like to visit? * (1 required)
Preschool & Elementary School (2905 NE 46th Ave. Des Moines) Middle School (1701 E. 33rd St. Des Moines) High School (1701 E. 33rd St. Des Moines) Both Schools
54. Any questions/concerns in particular you would like to discuss?
55. I prefer to be contacted by: *
Phone Email
56. Enter Your Email Address: *
57.