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New Student Visit Form

1. How did you find out about GVCS? *(Required)

4. Address(Required)
5. Relationship to Student: *(Required)
10. Student #1 Current Grade: *(Required)
11. Does Student #1 have a current IEP or 504 plan?(Required)
12. Has student #1 been on an IEP or 504 plan in the past? *(Required)
13. Does student #1 participate in an (ESL) English Second Language program? *(Required)
14. Has student #1 been diagnosed with any social/emotional disorders? *
15. If yes, please choose one. If no, disregard:
17. Has student #1 ever been suspended or expelled from school? *(Required)
21. Student #2 Current Grade:
22. Does Student #2 have a current IEP or 504 plan?
23. Has student #2 been on an IEP or 504 plan in the past?
24. Does student #2 participate in an (ESL) English Second Language program?
25. Has student #2 been diagnosed with any social/emotional disorders?
26. If yes, please choose one. If no, disregard:
28. Has student #2 ever been suspended or expelled from school?
32. Student #3 Current Grade:
33. Does Student #3 have a current IEP of 504 plan?
34. Has student #3 been on an IEP or 504 plan in the past?
35. Does student #3 participate in an (ESL) English Second Language program?
36. Has student #3 been diagnosed with any social/emotional disorders?
37. If yes, please choose one. If no, disregard:
39. Has student #3 ever been suspended or expelled from school?
43. Student #4 Current Grade:
44. Does student #4 have a current IEP or 504 plan?
45. Has student #4 been on an IEP or 504 plan in the past?
46. Does student #4 participate in an (ESL) English Second Language program?
50. Has student #4 ever been suspended or expelled from school?
48. If yes, please choose one. If no, disregard:
50. Has student #4 ever been suspended or expelled from school?
53. Which school would you like to visit? * (1 required)
55. I prefer to be contacted by: *(Required)

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