The SAM School | 2021-2022 Elementary School Application

Thank you for your interest in SAM Elementary. We are proud to offer an extraordinary educational experience to our students and look forward to learning more about your family through the application process. Here are the steps:

Step 1:

Fill out the online application below. Please note the application needs to be completed in one sitting as it will not save on our system until you click submit. We recommend looking over the questions and answering the long form questions on a separate document. When you have completed all of the questions, paste and submit. Our application is due on December 20, 2020. After that date we will accept applications for those classes where space is available.

Step 2:

We are excited to meet your children! Due to Covid-19 constraints we will determine how to achieve this as safely as possible on a case by case basis. We might invite your child to a virtual visit or arrange to meet in an outdoor space where distancing is possible.

Step 3:

You will receive a letter via email that shares the admissions decision as well as any relevant next steps.

Tuition Schedule

Kindergarten – Monday-Thursday, 8:30am -3:30 pm, Friday 8:30am – 1:30pm – $33,000

Grade 1/2 -Monday-Thursday, 8:30am -3:30 pm, Friday 8:30am – 1:30pm – $33,000

*Please note children must be of age by October 20, 2020

Student Information
Child's Name*
Child's Hebrew Name*
Date of Birth*
Hebrew Date of Birth*
Sex*
- Male
- Female
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Home Telephone
Parents or Legal Guardians
Fathers Name (or guardian)*
Mothers Name (or guardian)*
Occupation
Father
Mother
Address
Father (if different from child)
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Mother (if different from child)
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Cell Phone
Father*
Mother*
Email Address
Father*
Mother*
Primary Synagogue Affiliation*
If other, please indicate:
Questions
1. Please describe your child's skills and interests, strengths and challenges*
2. Please share information about your child's behavior, habits and attitude*
3. Please describe the reasons you are applying to The SAM School*
4. How did you hear about our school?*
Education History
5. Please list your child's education history (Include name of school, grade, and dates attended)*
Reference letter from current teacher (PDF)
Accepted file types: pdf.
You may upload here or send to admissions@thesamschool.org
6. Has your child ever received an educational evaluation? If yes, please attach. (PDF)
Accepted file types: pdf.
7. Has your child ever received support services (ST, PT, OT, SEIT, etc)? If yes, please explain.
8. Please list sibling Information
Sibling 1 - Name, Age, and School
Sibling 2 - Name, Age, and School
Sibling 3 - Name, Age, and School
Grandparent Information
Maternal Grandparents
Grandmother*
First Last
Grandfather*
First Last
Paternal Grandparents
Grandmother*
First Last
Grandfather*
First Last
Program Selection
Elementary School Program selection (select one):*
- K (5 yrs) 8:30am - 3:30pm Monday-Thursday 8:30-1:30 Friday
- 1st (6 yrs) 8:30am - 3:30pm Monday-Thursday 8:30-1:30 Friday
- 2nd (7 yrs) 8:30am - 3:30pm Monday-Thursday 8:30-1:30 Friday
(Note: Child must be of age no later than October 20, 2020) * PA Dues Additional *Lunch and snack program included.
A $150 non-refundable application fee is required with your completed application.
Deadline to submit applications: December 20th, 2020
Sign & Date
Signature*
Todays Date*
Product Name
Total
$0.00

2021-2022 Elementary School Application

Thank you for your interest in SAM Elementary. We are proud to offer an extraordinary educational experience to our students and look forward to learning more about your family through the application process. Here are the steps:

Student Information

Parents or Legal Guardians

Occupation

Address

Cell Phone

Email Address

Questions

Education History

8. Please list sibling Information

Grandparent Information

Maternal Grandparents

Paternal Grandparents

Program Selection

Deadline to submit applications: December 20th, 2020

Sign & Date