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Required
Today's Date
Name of Student
Age
Date of Birth
Parents' names
Address
Email
Home phone
Work phone
Cell
Current Grade Level
Please Select…
Grade 4
Grade 5
Grade 6
Grade 7
Grade 8
Date/Grade entered TCA
Previous school
Applying for:
Please Select…
Current School Year 2024-25
Next School Year 2025-26
If applicable, date first entered Lower School Academic Resource Center:
Students – Complete the following questions in an honest, thorough and thoughtful manner. Please answer all questions on your own.
Describe the way your learning difference impacts your learning now (such as speaking, listening, taking notes, spelling, reading and writing compositions):
How do you think the Academic Resource Center would benefit you?
What are the things you do well?
What academic subjects do you enjoy most?
What academic subjects are an extra challenge?
Are you involved in any sports, extracurricular activities or part-time jobs? Please list.
Parents – Please complete the following section.
Parents' names
What are the difficulties your son/daughter is experiencing?
In what subject is your son/daughter particularly strong or weak?
Does your child enjoy school?
Please list any remedial programs in which your child has participated, such as Alphabet Phonics, etc.
Does you child currently recceive any outside tutoring?
Yes
No
If so, by whom? (current and past)
Subjects tutored in:
Are the programs and/or tutors successful?
Yes
No
Please explain.
Does your child have current testing (within 3 years) documenting a specific learning disability based on State of Texas Guidelines and/or ADHD?*
Yes
No
If so, name of tester:
*
required
Date of first evaluation
*
required
Child's age and grade at time of testing
*
required
Diagnosis
*
required
Name of re-evaluation tester:
*
required
Date of re-evaluation
*
required
Submission of a current (within three years) and complete battery of psychoeducational testing is a requirement for enrollment in the TCA ARC program. Please submit all previous testing documents for our files.
Max file size: 10 MB
Please send a confirmation email to the address below*: