Application

If you plan to apply to Chelsea School for the 2018-2019 school year and need financial aid—either as a currently enrolled student or first time applicant—it is highly recommended that you complete the FAST process immediately at the start of 2018. This application is able to be accessed on January 1, 2018. Please note that financial aid is based on financial need and is provided on a first come – first served basis. There is limited funding available and current recipients of financial aid receive priority.

Decisions on financial aid will not be made until after the 2018 tax deadline. Please have tax information entered into FAST by April 15th. Financial aid will be awarded in May of 2018.

Click here to learn more about our school, our staff and our students, and what makes Chelsea unique, or contact Debbie Lourie, our admissions director, to take a tour.

Student Information:
Student's FULL Name
First Middle Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Social Security Number
Phone
Present School
Age
Current Grade
Birth Date
Division
Please indicate the division for which the student is applying
Grade
Desired Date of Entry
Has the student applied to Chelsea School before?*
- Yes
- No
If so, when? (month)
(year)
Person or Agency Responsible for Tuition:
Full Name*
First Last
Occupation
Relationship
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Home Phone
Cell Phone
Work Phone
Email
Which is the best way to reach you?
Parent / Guardian Information
Full Name*
First Last
Occupation
Relationship
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Home Phone
Cell Phone
Work Phone
Email
Which is the best way to reach you?
Who else resides in the home with the student?
Name
First Last
Relationship
Name
First Last
Relationship
Name
First Last
Relationship
Additional Information
What are your child's strengths?
What are your child's areas of greatest need?
Has your child received any special education services?
- Resource Room
- Speech / Language Therapy
- Occupational / Physical Therapy
- Self-Contained Special Education Class
- Counseling
- Tutoring
- Other
Other
Is your child receiving medication?
Please list the name and dosage and describe the condition for which it is being given.
Has your child exhibited behavioral problems at school?
Please describe circumstances.
Has your child been absent from school for an extended period of time?
Please explain the circumstances.
Has your child been hospitalized?
Please explain the circumstances.
Educational History Chart
Name of School
Phone
Dates Attended
To
Reason for Leaving
Name of School
Dates Attended
Phone
To
Reason for Leaving
Name of School
Phone
Dates Attended
To
Reason for Leaving
Professionals Currently Working With Your Child
Name of Professional
First Last
Phone
Position
Name of Professional
First Last
Position
Position
Phone
Name of Professional
First Last
Position
Phone
Name of Professional
First Last
Position
Phone
Name of Professional
First Last
Position
Phone
What is your child's attitude toward school?
What are your child's interests outside of school?
What qualities about Chelsea School make you believe that it would be a good place for your child?

Application

Student Information:

Person or Agency Responsible for Tuition:

Parent / Guardian Information

Who else resides in the home with the student?

Additional Information

Educational History Chart

Professionals Currently Working With Your Child

RESOURCES

CONTACT