Request Information

Let Esther B Clark School-childrens Health Council know that you are interested in learning about their school. Provide your information below to request this school's viewbook and application. Your request will typically be processed within 24 hours. If you have more specific questions for this school, please use our Email Schools form instead.

Notes for Prospective Students

Must see recent ( within 2 years) psycho-educationsl testing report with cogintive and academic standard scores as well as social emotional rating scales. The student's current and past IEP, Behavior Suport plan and any Incident reports from the past six months must also be included.

Student Information

Email:

Name of parent:

Student first name:

Student last name:

Student date of birth:

Student is:

Male

Female

Currently in grade:

Seeking entry for grade:

Target start date:

About the Student

Please briefly describe academic, athletic, and extracurricular interests of the student:

Address and Telephone Number

Home address:

City:

Country:

State:

Zip: (enter "N/A" if not applicable)

Phone:

Save this data and create your user profile. Create your own user account so you don't have to re-type your user data each time you request information. You'll also be able to track your information requests, get reminded of application dates, and more!

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