Chewonki Elementary and Middle School 2021-2022 Application Thank you for completing the information in this application. If you have questions about the application process, please contact us at admissions@chewonki.org.* Indicates required field Student Information First Name Middle Name Last Name Preferred Name/Nickname GenderPlease select... Male Female Self-identify Please indicate how the student identifies. Check one or more. Providing this information is optional. AsianBlack or African American (including Africa and the Caribbean)Hispanic or LatinoMiddle EasternMultiracialNative American or Alaska Native (including all Original Peoples of the Americas)Native Hawaiian or Other Pacific Islander (Original Peoples)WhiteOther/Unknown Date of birth Address Street Address Address Line 2 City State / Province / Region Postal / Zip Code Anticipated grade level September 2021Please select... 1st 2nd 3rd 4th 5th 6th 7th 8th Chewonki values diversity in many forms. If you would like to share any information about your child's background (race, ethnicity, gender, religion, etc.) please do so below. We aim to reasonably accommodate the needs of all students. Please be specific about any dietary, medical or mental health needs that may affect your child's ability to fully participate in classroom and outdoor activities at Chewonki. Any high-risk medical needs will be evaluated on a case-by-case basis. If you would prefer, you may speak with our supervising nurse at 882-7323 ext. 117. Parent / Guardian Information Parents are:MarriedSeparatedDivorcedWidowedSingleNever marriedOther Parent / Guardian 1 TitleMs.Mrs.Mr.Dr. First Name Middle Name Last Name Preferred Name/Nickname Parent 1 address (if different from above) Street Address Address Line 2 City State Postal / Zip Code Employer Job Title Relationship to student applyingMotherFatherStep-MotherStep-FatherLegal GuardianOther Home Phone Number Mobile Phone Number Work Phone Number Preferred phone numberPlease select... Home Mobile Work Parent Email Parent /Guardian 2 TitleMs.Mrs.Mr.Dr. First Name Middle Name Last Name Preferred Name/Nickname Parent 2 Address (if different from Parent 1) Street Address Address Line 2 City State Zip Employer Job Title Relationship to student applyingMotherFatherStep-MotherStep-FatherLegal GuardianOther Home Phone Number Mobile Phone Number Work Phone Number Preferred Phone NumberPlease select... Home Mobile Work Email Additional Information Siblings' names and ages Have you or a relative ever participated in a Chewonki Program? If so, what program? Current School Information Are you considering other schools for the 2021-22 school year?YesNo Will you be applying for financial aid from Chewonki?YesNo Parent Questions Please answer the following questions in 250 words or less. Tell us about your child's current extra-curricular activities. Why do you think Chewonki would be a good choice for your child and family? Tell us about your child's strengths, challenges, and uniqueness. Please add anything we should know when considering your child as a good match for this place-based school? Prospective Student Questions Please have a conversation with your child about his or her interests in school and outdoor activities.Answers only need to be a few sentences each. What do you like most about school? How do you feel about a new school next year? What are your favorite things to do outside? Student recommendation will be provided by Recommender's position Recommender's Email How did you hear about Chewonki Elementary and Middle School? Please be as specific as possible (website, friend, newspaper). If a current Chewonki family referred you, please include their name. Thank you. You will receive a confirmation email upon submission. Contact Information
