Visit our Campuses New Student Visit Form 1. How did you find out about GVCS? *(Required) GVCS Gala Friend/Family Social Media/ Website Online Search Church News Media Sporting/Fine Arts Event Other 2. Names of Parents/Guardians *(Required) 3. Phone Number: *(Required)4. Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code 5. Relationship to Student: *(Required) Guardian Grandparent Parent Other (please note below) 6. If other, please list here: 7. Church: *(Required) 8. Student #1 Name: *(Required) 9. Student #1 Current School: *(Required) 10. Student #1 Current Grade: *(Required) Preschool Kindergarten 1st 2nd 3rd 4th 5th 6th 7th 8th 9th 10th 11th 12th 11. Does Student #1 have a current IEP or 504 plan?(Required) Yes No 12. Has student #1 been on an IEP or 504 plan in the past? *(Required) Yes No 13. Does student #1 participate in an (ESL) English Second Language program? *(Required) Yes No 14. Has student #1 been diagnosed with any social/emotional disorders? *(Required) 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? *(Required) Yes (if selected, please explain below) No 18. If yes, please explain. If no, disregard: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 or 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 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 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 50. Has student #4 ever been suspended or expelled from school? Yes (if selected, please explain below) No 48. If yes, please choose one. If no, disregard: Anxiety Autism Depression Other 50. Has student #4 ever been suspended or expelled from school? Yes (please select 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: *(Required) Phone Email 56. Enter Your Email Address: * Campuses