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Independent School Washington DC - The River School Facebook

Where Small Steps Become Giant Leaps.

Knowing first steps are foundational,
we’ve been 18 months - Grade 3 since 2000.
Now we've grown an Upper Elementary program (Grades 4-5)!
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About Us
Educational Approach
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2020-21 School Year Application NO CREDIT CARD

Application - 2020-21 NO CREDIT CARD

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General Information
Child's Name*
Please use your child's legal name.
First Last
The name your child is called (first name or nickname if applicable)*
Date of Birth*
Example: 01/30/12
Gender*
Hidden
Image of Child
jpg, gif, png, bmp, pdf are all accepted image formats
Accepted file types: jpg, gif, png, bmp, pdf, Max. file size: 5 MB.
Image of Child
We recommend uploading a JPG, but gif, png, pdf are all accepted image formats. File size limit is 5 MB.
Drop files here or

Accepted file types: jpg, gif, png, bmp, pdf, Max. file size: 5 MB.
If you prefer, you may email a photo to us: Email Photo
How old will your child be:*
- 18 months by September 1, 2020
- 2 years by September 1, 2020
- 2 ½ years by September 1, 2020
- 3 years by September 1, 2020
- 4 years by September 1, 2020 - PreK
- 5 years by September 1, 2020 - Kindergarten
- 6 years by September 1, 2020 - 1st Grade
- 7 years by September 1, 2020 - 2nd Grade
- 8 years by September 1, 2020 - 3rd Grade
The following enrollment options are available based on your child's age:
- Two Mornings (8:25 am - 11: 50 am)
- Three Mornings (8:25 am - 11: 50 am)
- Five Mornings (8:25 am - 11: 50 am)
- Five Full Days (8:25 am - 2: 50 pm)

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Family Information
Parent/Guardian Name*
Parent/Guardian Name
First Last
Email*
Cell Phone
Home Phone
Home Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Employer*
Job Title*
Employer Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Business Phone
Add another Parent/Guardian?
- Yes
- No
Parent/Guardian Name*
First Last
Email
Cell Phone
Is the home address the same as above?
- Yes
- No
Home Phone
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Employer
Job Title
Employer Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Business Phone
Do you have other children in the family?*
- Yes
- No
Other Children
Name Date of Birth School Attending Gender

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More About Your Child
What other schools or programs has your child attended? List the schools/programs as well as years attended.
What other group experiences has your child had?
Describe your goals for your child’s school experience.

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Personal Characteristics
Is your child learning other languages?
- Yes
- No
Which language(s)?
What is your child’s primary language or means of communication?
Describe any individualized support your child would benefit from.
Describe your child’s strengths and interests.
Does the child you are applying for have hearing loss?*
- Yes
- No
Hearing Related
Prenatal History - Did the mother have any of the following conditions during pregnancy?
- Bleeding
- Fevers
- Toxemia
- Pre-exclampsia
Was the mother on bed rest at anytime?
- Yes
- No
How long and why was the mother on bed rest?
Was the baby:
- Full Term
- Premature
What was the number of weeks of the babys gestational age?
Were there any complications during the delivery?
- Yes
- No
Briefly explain any delivery complications:
Was your child adopted?
- Yes
- No
At what age was your child adopted?
Did your child pass the newborn screening?
- Yes
- No
Briefly describe how you learned of your child’s hearing loss, including the date the hearing loss was first diagnosed by an audiologist.
Family history of hearing loss:
Etiology (cause) of the hearing loss (if known):
Degree of hearing loss in right ear:
- Mild
- Moderate
- Severe
- Profound
Degree of hearing loss in left ear:
- Mild
- Moderate
- Severe
- Profound
Type of hearing loss:
- Sensorineural
- Conductive
- Mixed
- Don't Know
Name of your child's ENT:
Did you child ever use hearing aids?
- Yes
- No
List dates of hearing aid use (e.g., 1/1/02 – 8/03):
What type of hearing aid?
Briefly describe how your child responded to hearing aids. Did your child tolerate wearing them all day, every day? Did your child respond to environmental noises? Did your child respond to your voice while wearing hearing aids? Do you know/remember your child’s hearing thresholds while wearing hearing aids (e.g. 60 dB)?
Date of cochlear implant surgery:
Name of hospital and surgeon:
Date of activation:
Name of implant center that programmed and currently follows your child:
Name of child’s current audiologist:
Model of implant (e.g. Nucleus 5, Advanced Bionics):
Type of speech processor (e.g. BTE or Body Worn):
Current hearing threshold (e.g. 25 dB):
List name and specialty of any other professionals currently working with your child (e.g. deaf educator, speech pathologist, physical/occupational therapist):
Other pertinent information you would like to share:
LANGUAGE/SOCIAL - Indicate the age at which your child first demonstrated the behaviors listed below:
Smiled at caregiver
Babbled
Understood single words (e.g., raised arms upon hearing “up”)
Waved “bye-bye”
Said first word other than mama or dada
Followed simple commands (e.g. “Come here.”)
Put two words together
Number of words (approximately) by 24 months
Spoke in sentences
Was there ever a period when your child’s speech or language development slowed down, stopped, or regressed?
- Yes
- No
Note the age and describe the language change:
What is the primary language spoken at home?
Are there any other languages spoken?
Do you have concerns regarding your child’s speech or language?
- Yes
- No
Check all that apply:
- Is/was late beginning to talk
- Does not understand humor
- Stutters
- Hard to understand
- Mispronounces sounds
- Echoes others
- Has difficulty telling stories
- Has trouble following directions
- Repeats phrases
- Forgets previously used/learned vocabulary
- Talks less than other children the same age
- Has trouble thinking of the words for things
- Other (add below)
Other (from above)
Does your child seem to understand what is said to her/him?
- Yes
- No
How does your child respond (ignore, wait for repetition, offer inappropriate responses)?
Which responses best describe your child’s current language:
- single words
- phrases (e.g. “mommy shoe”)
- complete grammatically sentences
- complete but grammatically incorrect/incomplete sentences (e.g. “boy going home”)
Do you use sign language to communicate with your child?
- Yes
- No
List the words your child consistently signs to communicate:
Do you have difficulty understanding what your child is saying (i.e., speech)?
- Yes
- No
Do less familiar listeners have a difficulty understanding your child?
- Yes
- No
How would you describe your child’s voice?
- Too Soft
- Too Loud
- Average
- Hoarse
- Nasal
- Hyponasal (stuffy)
GROSS MOTOR - Indicate the age at which your child first demonstrated the behaviors listed below:
Sat alone
Crawled
Stood alone
Walked alone
Ran
Rode a tricycle
Can he ride a bike?
- Yes
- No
With or without training wheels?
- With
- Without
Describe your child’s gross and fine motor skills. Have you noticed anything unusual in this area?
Are you concerned about your child’s motor skills? Why?
FINE MOTOR - Indicate the age at which your child first demonstrated the behaviors listed below:
Grasped rattle
Reached for object
Passed toy from hand to hand
Held object between thumb and finger
Drank from cup
Scribbled
Could use a spoon spilling a little
Washed and dried hands
Pulled on own clothes
Fed self
Dressed self
Tied own shoes
Drew circle
Toilet trained for daytime
Totally toilet trained
Wrote name
Has your child’s vision been tested?
- Yes
- No
What were the results of the vision test?
Has your child ever been seen by a pediatric specialist (e.g. neurologist)?
- Yes
- No
Name of specialist:
Why was the child seen?
List all hospitalizations and surgeries, including the child’s age at the time (other than CI surgery):
List any serious or chronic illnesses (e.g. ear infections, ear tubes, chicken pox):
Does you child have any allergies or dietary restrictions?
- Yes
- No
Specify allergies and /or dietary restrictions:
Is your child taking any medications? If yes, indicate the type of medication, dosage, and reason:
Has your child previously taken any medications? If yes, indicate the type of medication, dosage (if known), and reason:
At what age did your child stop bottle feeding?
Stop using a pacifier?
Start eating solid foods?
Does your child have any feeding difficulties?
Does your child have a good appetite?
- Yes
- No
Describe what your child eats including textures (smooth, crunchy, chewy, etc.):
Is your child a messy eater?
- Yes
- No
Does your child tend to stuff his/her mouth?
- Yes
- No
Describe any other oral behavior your child has (thumb sucking pacifier use, mouthing toys or other objects, biting, etc.):
List your child’s favorite toys and describe how he/she plays with them:
Does your child play on her/his own?
- Yes
- No
Does your child use his/her imagination when playing?
- Yes
- No
Describe how/what you play with your child:
What opportunities does your child have to play with other children of various ages?
Select who your child prefers to play with:
- younger
- same age
- older children, or adults
Are you concerned that your child does not play well with other children?
- Yes
- No
Provide any details:
List all schools your child has previously attended along with the corresponding grade levels and dates:
Name of school or program your child currently attends:
City and county of school:
School Telephone:
Your child’s grade or level in school:
Your child’s current teacher(s):
Your child’s relationship to present teacher and previous teachers:
Is your child experiencing any learning or social problems at school?
- Yes
- No
If so, explain your child's learning or social problems at school.
Areas of greatest academic interest and grades received:
Has your child repeated any grades?
- Yes
- No
Which grades has your child repeated?
Does you child receive any special services at school or outside of school?
- Yes
- No
Speech-language therapy - indicate how often the service is provided.
Occupational therapy - indicate how often the service is provided.
Sensory integration - indicate how often the service is provided.
Physical therapy - indicate how often the service is provided.
Reading resource - indicate how often the service is provided.
Other - indicate how often the service is provided.
Supplementary Reports
Drop files here or

Accepted file types: pdf, Max. file size: 10 MB, Max. files: 20.

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How You Found The River School
How did you hear about The River School? Select one and provide additional information:*
- Friend/Word of Mouth
- Print Advertising
- Online Advertising
- Internet Search
- Direct Mail
- School Fair
- Outdoor Signage
- Other
Please specify your referral source/name*
Will you be applying for Financial Aid?*
- Yes
- No
Name of person filling out application*
Date*
MM slash DD slash YYYY
Signature*
Thank you for taking the time to complete this application. The information you have provided will be treated confidentially following HIPAA guidelines and will greatly assist us in getting to know you and your child.

The River School does not discriminate on the basis of race, color, national and ethnic origin, gender, or religion in the administration of its educational policies, admission policies, scholarship programs and other school administered programs.
Billing and Payment Information

There is a $60 non-refundable application fee. We are experiencing difficulties with our website credit card processing system and are working on a solution. If you'd like to pay by credit card over the phone, please contact Chris Lopez in the Business Office at 202-380-9214; or mail a check to:

The River School
4880 MacArthur Boulevard, NW
Washington, DC 20007
Application Fee
Price:
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Premier, Personalized Education

Preschool and Elementary Programs

Play-Based, Thematic Curriculum

4880 MacArthur Boulevard, NW
Washington, DC 20007
Tel: 202-337-3554

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River Cares / River Walk

Katie Atkinson
Elizabeth & Rep Burks
Megan Campbell
Caroline Nolan & Jonathan Carpenter
Kristin Rae Cecchi & G. John Cecchi
Elizabeth Adams Costa & Richard Costa
Shannon & Matthew Graham

Johanna & Ryan Greene
Annie & Michael Hanson
Elizabeth & Dominic Kiley
Jenna & Sia Madani
Margaret I. Cuomo, MD & Howard Maier
Ameerah Abdullah & Jack Miles
Randi & Jason Rosenberg

Heather French & Hans Miller
Aisha Riley
Jessica & Neil Sitron
Dana Lee & Christopher Tavlarides
Jennifer Stiddard & Ryan Thomas
Deana & Peter O’Hara
Katrina Kosec & Fabian Valencia

River Cares

Alex Moe & William Wilhelm

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