Application for Assessment

Alison Young
Assistant Director
619-243-1400
619-466-1448 FAX

You may choose to fill out the Application for Assessment on line or you may opt to print out the PDF version, which you can mail or fax to Mt. Helix Academy. Either way, we will contact you as soon as possible to arrange for your child’s assessment. Thank you for your interest in Mt. Helix Academy.

Application for Assessment (PDF)

On-line Application for Assessment
We greatly appreciate your taking the time to fill out the Application for Assessment as completely as possible. Please note that some items must be completed or you will not be able to submit the form. Thank you for your time and we are eager to get to know you and your child.

Child's Info

1. Child's First NameThe above field is required. Please complete it accurately.
2. Child's Last NameThe above field is required. Please complete it accurately.
3. New Field
4. New Field

Mother's Info

1. Mother's Last NameThe above field is required. Please complete it accurately.
2. Mother's First NameThe above field is required. Please complete it accurately.
3. Daytime Phone # • Preferably Cell #
4. Email AddressPlease enter a valid email address.

Father's Info

1. Father's Last Name
2. Father's First Name
3. Daytime Phone # • Preferably Cell #
4. Email Address

Additional Items

1. Does your child have an Individualized Education Plan (IEP)?
2. Y N
3. I/We understand that the Assessment for Enrollment in Mt. Helix Academy incurs a one-time non-refundable fee.
4. Y N
5. Do you hereby agree that all the information provided on this form is true and that you are who you say you are?
6. Y N
7. Enter Antispam Code

 

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