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Application for Admission 2025-26

Checklist of Admission Items

Application for Admission
Teacher Evaluation Form(s)
Copies of any available diagnostic reports or developmental evaluations
Non-refundable application fee of $100

Please note this form opens on a time-limited basis and must be completed in one sitting. It appears to work best when using Chrome. We recommend you review the questions and prepare your responses in a separate document. You can then reopen the form and submit your responses. Thank you for your cooperation. Questions? Please email Admissions@madduxschool.org.

Student Name (Last, First) *

Prefers to be called *

Date of Birth (MM-DD-YYYY) *

Language Spoken at Home *

Child's Race/Ethnicity (Select all that apply.)

American Indian or Alaska Native
Asian
Black or African American
Hispanic or Latino
Middle Eastern or North African
Native Hawaiian or Pacific Islander
White

Grade Applying to *

Pre-K
Kindergarten
First Grade
Second Grade
Unsure

How did you learn about The Maddux School? *

Current School *

Previous School *

Please upload your child's recent photo

List of Allowed file types

What are your child's strengths? *

What are your child's challenges? *

Does or has your child receive(d) 1:1 support in school or daycare? If yes, please describe. *

How does your child relate to peers and adults? *

How does your child learn best? *

How do your child's social skills and maturity compare to his/her peers? *

How do your child's communication skills and concept development compare to his/her peers? *

Please describe any support your child relies on for using the bathroom (e.g., reminders; help with cleanup; help with dressing; etc.) *

Does your child demonstrate any behavioral difficulties at home or in school? *

What do you hope your child will gain from attending this program? *

Assessment/Evaluation Information

	Date(s)	Name of Evaluator	May we contact this Evaluator?	Contact Phone/Email
Speech/ Language Eval
Occupational Therapy Eval
Developmental Eval
Psychological Eval
Other
Other

Please upload copies of the above-listed reports or email to Admissions@madduxschool.org.

Add attachment

List of Allowed file types

Current and/or Previous Services Received

	Dates	Name of Provider	May we contact this provider?	Contact Phone or Email
Play Therapy/ Social Skills
Speech/Lang Therapy
Occupational Therapy
Special Ed Services
ABA Programming
Other

Please upload additional reports or information or email them to Admissions@madduxschool.org.

Add attachment

List of Allowed file types

Other comments

Parent/Guardian Information

	Parent/Guardian 1	Parent/Guardian 2
Name (Last, First)
Address Line 1
Address Line 2
City, State, Zip
Cell Phone
Email
Occupation
Employer

A $100 non-refundable application fee must accompany this application. Please check one of the following options. *

I will mail a check made payable to The Maddux School to the address listed above.

I prefer to pay online through Xpress-pay. I understand there is a 2.75% fee for this service. (If you select this option, you will receive an email containing a link to the Xpress-pay site.)

Parent Email *

Parent Signature

Type your name and sign below

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Thank you so much for your interest in The Maddux School. If your child appears to be an appropriate candidate, we will contact you to schedule an in-person visit. Please feel free to contact us if you have any questions. Admissions@madduxschool.org