Apply Online - Quaker School at Horsham

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APPLICANT INFORMATION
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Applicant Name:required

First Name

Middle (optional)

Last Name

Suffix (optional)

Applicant Preferred Name: (if different from above)

Date of Birth:required

Must contain a date in M/D/YYYY format

Gender:required

Pronouns

Ethnicity

Current Grade: (Grade During 2025-2026 School Year)required

Applicant for Grade:required

Current School:required

Applicant Year:required

Does Applicant have an IEP or Other Evaluation?required

Are you pursuing Financial Aid?required

Are you pursuing School District Funding?required

Does Applicant qualify for free or reduced lunch at their current school?required

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HOUSEHOLD INFORMATION
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PRIMARY HOUSEHOLD INFORMATION

Primary Home Address:required

First Parent/Guardian in Primary Household

Name:required

Prefix (optional)

First Name

Middle (optional)

Last Name

Suffix (optional)

Relationship to Applicant:required

Primary Phone Number:required

Primary Email Address:required

Employment Status:required

Title/Occupation:required

Employer Name:required

Work Phone Number:

Work Address:

Is there a Second Parent/Guardian in Primary Household?required

Yes

No

Name:required

Prefix (optional)

First Name

Middle (optional)

Last Name

Suffix (optional)

Relationship to Applicant:required

Primary Phone Number:required

Primary Email Address:required

Employment Status:required

Title/Occupation:required

Employer Name:required

Work Phone Number:

Work Address:

SECONDARY HOUSEHOLD INFORMATION

Does the Applicant have a Second Household with a Legal Guardian?required

Yes

No

Secondary Home Address:required

First Parent/Guardian in Secondary Household

Name:required

Prefix (optional)

First Name

Middle (optional)

Last Name

Suffix (optional)

Relationship to Applicant:required

Primary Phone Number:required

Primary Email Address:required

Employment Status:required

Title/Occupation:required

Employer Name:required

Work Phone Number:required

Work Address:

Second Parent/Guardian in Secondary Household

Is there a Second Parent/LegalGuardian in this Household?required

Yes

No

Name:required

Prefix (optional)

First Name

Middle (optional)

Last Name

Suffix (optional)

Relationship to Applicant:required

Primary Phone Number:required

Primary Email Address:required

Employment Status:required

Title/Occupation:required

Employer Name:required

Work Phone Number:

Work Address:

Legal And Physical Custody

Do both Mother and Father have Legal and Physical Custody?required

Yes

No

Who has Legal Custody?

Please specify Name(s) and Relationship to Applicant?

Who has Physical Custody?

Please specify Name(s) and Relationship to Applicant?

How many Siblings, if any, does the Applicant have?

How many of these siblings currently reside in the home?

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ACADEMIC INFORMATION
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Please list all Schools Applicant has attended starting with the most recent.

Previous School Name:

School Phone Number:

Grade:

Has the Applicant attended another school?

Yes

No

Previous School Name:

School Phone Number:

Grade:

Has the Applicant repeated a grade?

Yes

No

Which grade (s) were repeated?

Assessments, Evaluations & Therapies:

Does the Applicant have a formal diagnosis(es)?required

Yes

No

Please listrequired

Please describe:

Has the Applicant been hospitalized for mental health support?required

Yes

No

Please specify dates and facilities.

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