Applicant Information
| Student Name: | Swanson King | Date | May 31, 2011 |
|---|---|---|---|
| Sex | Male | Place of Birth | LaPlata,Maryland, United States |
| Email Address: | cfenelus@wmata.com | Home Address | 300 T Street N.E. Washington, DC 20002 |
| Siblings | [] | ||
| Name | Grade | ||
| Religion: | None | Baptized: | YES |
| Local Public School System: | Kipp Heights | Local Public School Child Would Attend: | Washington Global Academy |
| Race of the Student: | Two or more races | Ethnicity of Student: | Non-Hispanic |
Family Information
| Mother | Father | |
|---|---|---|
| Full Name | Claire Fenelus | Lamont Swanson |
| Maiden Name | Fenelus | Swanson |
| Country of Birth | USA | USA |
| Home Address | 300 T Street NE | 5515 Volta Avenue |
| Home Phone | (202) 704 7001 | (973) 932 2563 |
| Mother Cell Phone | (202) 704 7001 | (973) 932 2563 |
| Preferred Email | cfenelus@wmata.com | ljsswanson@gmail.com |
| Mother Occupation | Supervisor | Unemployed |
| Employer | Metro | |
| Mother Work Phone | (301) 955 2240 | |
| Religion | None | None |
| Parish/Church |
| Parents’ Marital Status: | Single | Student lives with: | Mother Only |
|---|---|---|---|
| Full Name | Claire Fenelus | Country of Birth | United States |
| Home Address | 300 T Street NE | Preferred Email | cfenelus@wmata.com |
| Home Phone | (202) 704 7001 | Cell Phone | (202) 704 7001 |
| Occupation | Supervisor | Employer | Metro |
| Work Phone | (301) 955 2240 | Religion | None |
| Parish/Church | N/A | Person responsible for Tuition/Fee Payments: |
Claire Fenelus |
| Address, City, State, ZIP: | 300 T Street NE Washington, DC 20002 | Phone & Email: | (202) 704 7001 |
Emergency Contact Information
| Contact #1: | Fenelus Claire | Relation to Student: | Mother |
|---|---|---|---|
| Email Address: | cfenelus@wmata.com | Home Address: | 300 T Street NE Washington, DC 20002 United States |
| Home Phone | (202) 704 7001 | Other Phone | (202) 264 0450 |
| Contact #2 | Swanson Lamont | Relation to Student: | Father |
| Email Address | ljsswanson@gmail.com | Home Address: | 5515 Volta Avenue Bladensburg, MD 20710 United States |
| Other Phone | (973) 932 2563 | Home Phone |
Student Background Information
| Does your child need any particular academic enrichment in order to be successful in school? | NO |
|---|---|
| If yes, please explain briefly (other forms will be required): | |
| Has your child received special services from a professional (e.g. counselor, speech therapist, special education teacher)? | NO |
| Briefly describe the type of service, length of service, and if it discontinued, a reason for discontinuation: | |
| Does your child need accommodations to be successful in school? | NO |
| Please list: | |
| Does your child have any diagnosed allergies? | YES |
| If yes, please list (other forms will be required): |
Allergic to Eggs, Nuts, and Seafood |
| Will your child require medication to be administered during the school day? | NO |
| If yes, please explain briefly (other forms will be required): | |
| Medical Diagnosis: Please check ✓ all that apply: | No known medical conditions |
| Physical Disability: | No existing physical disability |
| Learning Disorder: | No known learning disorder |
Home Language Survey
| Primary language(s) spoken in students household: | English |
|---|---|
| Does primary guardian speak English? | YES |
| Is the Student Bi-Lingual? | NO |
| Does the student spend significant time with a non-English speaking caregiver? | NO |
Transferring Students
| Is the student transferring from another school(s)? | YES |
|---|
| Dates Attended | School Name | City | Phone Number | Grade Avg |
|---|---|---|---|---|
| June 15, 2023 | Kipp | Washington | 6 |
For Catholic Applicants Only
| Current Parish: | Pastor: |
|---|
| Date | Church | City | State | |
|---|---|---|---|---|
| Baptism | ||||
| Date Reconciliation: | ||||
| Date First Eucharist | ||||
| Date Confirmation | ||||
| Date Other | Date Other |
Parent/Guardian Acknowledgment
| ALL STUDENT APPLICANTS | Non-Refundable Application Fee of $375.00, Copy of Valid Age Birth Certificate, Archdiocese of Washington Immunization Policy, Acknowledgment and All Attachments(Required for Admission), Copy of Baptismal Certificate (Catholics only), Allergy Action Plan (If Applicable), Copy of custody order, or other applicable court orders (If Applicable), All relevant evaluations/assessments and previous special education plans (If Applicable) |
|---|---|
| TRANSFER STUDENT APPLICANTS ONLY | Current standardized test scores plus the two previous years’ scores, Current report card including comments and the two previous years’ report cards |
| Mother Names of Parents/Guardians | Claire Fenelus |
| Father Names of Parents/Guardians | Lamont Swanson |
| Mother Signatures |
For Office Use Only
| Check ✓and Date when each item is received and verified |
|---|
| Applicant Name: |
| Application Received: |
| Application Fee Paid: |
| Baptismal Certificate: |
| Immunization Documents: |
| Birth Certificate: |
| If Applicable |
| Allergy Agreement :, |
| Custody Decree: , |
| Transfer Students ONLY: |
| Report Cards: , |
| Test Scores: , |
| Admissions Interview Completed: , |
| RELIGION: , |
| Catholic |
| Non-Catholic: |
| Parish Registration Form: , |
| STATUS: |
| Accepted: , |
| Denied: , |
| Grade:, |
| Homeroom Teacher: , : |
| Name: | Address: | ||
|---|---|---|---|
| Phone Number: | NOTES: |