Name *

First Name

Last Name

Phone *

(###)

###

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Student Name *

First Name

Last Name

Student Date of Birth *

MM

DD

YYYY

Date of Application *

MM

DD

YYYY

Please submit this application, along with the following documentation: *

Please forward all corresponding documents to edu@smithschool.org

Official Transcripts

Report Cards

Copies of all educational, academic and/or psychological evaluations

Current photo of your child

Copy of IEP/504 Plan (if available)

(2) Teacher Recommendation Letters

Student Writing Sample

Non-refundable $50 Application Processing Fee (check payable to The Smith School)