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A Nationally Recognized K-12 School for the Gifted Cincinnati, Ohio      Member of OAIS

Information Request Are you the guardian or prospective student? Guardian Information Name: Guardian's e-mail*: optional if the student's e-mail is entered below Student Information First name*: Middle name: Last name*: Student's e-mail*: optional if the guardian's e-mail is entered above Date of birth*: January February March April May June July August September October November December Gender female or male Country of citizenship United States of America other Please specify: Currently in grade* Preschool Kindergarten Not in school yet Seeking admission for grade Kindergarten Target start date Fall Spring Immediately Name of current school Type of school public   private   parochial   homeschool Will you be applying for financial aid? yes   no How did you hear about our school? internet family with a current student family with a former student newspaper phone book other From whom? About the Student Please describe the academic, athletic, and extracurricular interests of the student. You may also want to mention the type of school or programs your family is seeking. (Note: there is room for about two to four sentences.) Home Contact Information Street address City State Zip code Phone number* Type of phone home work cell

NONDISCRIMINATION POLICY The Schilling School for Gifted Children, Inc. recruits and admits students of any race, color, or national or ethnic origin to all the rights, privileges, programs and activities. In addition, the School will not discriminate on the basis of race, color, or national or ethnic origin in administration of its educational policies, scholarships/loans/fee waivers, educational programs and athletics/extracurricular activities. In addition, the School is not intended to be an alternative to court or administrative agency ordered, or public school district initiated, desegregation. The Schilling School for Gifted Children, Inc. will not discriminate on the basis of race, color, sex, age, religion or national or ethnic origin in the hiring of its certified or non-certified personnel.

8100 Cornell Road, Cincinnati, OH 45249   |   Phone: (513) 489-8940   |   Fax: (513) 489-8941   |   lmink@schillingschool.org