q/tj'/lry€¦ · the cunent school should mail the official school transcipt and reports...

Winston Preparatory Schooleducotion for the individuol

Dear Families,

Thank you for your interest in Winston Preparatory School. We are proud of our uniqueeducational program for students in grades 4-12 with learning differences. At Winston, eachstudent's program is designed to develop essential skills while challenging his or her strengths. lnour highly successful Focus Program, each student receives a daily period of one-to-oneinstruction concentrating on his or her greatest area of need. The implementation of the programhas allowed us to further personalize instruction and strategies so that our students can betterunderstand themselves, verbalize their needs and become independent learners. The process ofplacement and program design is informed by an in-depth understanding of the individual thatbegins with the information you share with us during the application process. Please refer to theenclosed application procedure checklist for further explanation of required information.Additionally, all prospective parents/guardians are required to attend an Open House and areasked to RSVP on our website at www.winstonprep.edu/apply-now. Please refer to the enclosedschedule to determine what date fits best within your schedule. Please contact the admissionsoffice with any other questions regarding the application process via telephon e (ZOI-ZZ9-O+OS,ext. 5600) or email ([email protected]).

We look forward to meeting you at one of our Open Houses and sharing information regardingWinston Preparatory School.

Respectfully,

q/tJ'/LryMichelle RolfeDirector of Admissions

ii'fr) www.winstonprep.edu

fl facebook.com/winstonprepschool

lt @WinstonPrep

New York126 West 17th StreetNew York, NY'i0011646-638-2705@WPSNY

Connecticut57 West Rocks RoadNorwalk, CT 06851203-229-O465@WinstonPrepCT

New Jersey9O1 Route 10 EastWhippany, NJ 07981973-500-6480@WinstonPrepNJ

Transitions Program240 Madison Avenue, 14th flNew York, NY 10016646-869-4600@WPTransitions


WPS APPLICATI ON CHECKLIST

Winston Preparatory School accepts students on a rolling basis. The following materials are required inorder to consider your application complete. Upon receipt of the above materials, the AdmissionsCommittee will review your application in an initial screening. lf the Committee believes the applicant maybe an appropriate match for our program, your child will be invited for a school visit and interview. Allapplicanis wltt Ue notified of the Committee's findings within three weeks of the initial screening and/orinterview. Winston is a school for students with specific learning disorders, such as dyslexia, ADHD andNonverbal Learning Disorders. Winston Preparatory School does not accept students with primarybehavioral or emotional symptoms.

Please forward all information to the campus you are applying to:

o Current (within 2 years) Psychoeducational or Neuropsychological Evaluation with cognitive,achievement and projective testing (see examples below). Please submit a copy. Do not submit theoriginal document.o Cognitive function: WISC lV or WISC V (Wechsler lntelligence Scale for Children).o Academic Achievement: WJ-lll Achievement (Woodcock Johnson lV) or WIAT lV

(Wechsler lndividual Achievement Test).o Projective Psychological Function: Rorschach and/or the Thematic Apperception Test

and/or BASC (Behavioral Assessment Scale for Children).

o Application for the 2019-2O2O Academic Year

o $ 100.00 Non-Refundable Application Fee (paid to Winston Preparatory School)

o Completed Parental Statement

o School Transcripts (Sent directly from your child's current placement.)

o Completed Teacher/Specialist Recommendation Form

o Completed lnformation Release Form

o Recent Photograph (Digital photos submitted via email are acceptable.)

o Attendance at a Prospective Parent Open House

Winston PreparatorySchool CT

Office of Admissions57 West Rocks RoadNorwalk, CT 06851

Winston PreparatorySchool NJ

0ffice of Admissions901 Route 10 East

Whippany, NJ 07981

Winston PreparatorySchool NY

Office of Admissions126 West l Tth StreetNew York, NY 1001 1

Winston PreparatorySchool Ll

Office of Admissions30 Deforest Road

Dix Hills, NY I 1746

rllt www.winstonprep.edu


tf @WinstonPrep

New York126 West 17th StreetNew York, NY 10011646-638-2705@WPSNY


New Jersey901 Route 10 EastWhippany, NJ 07981973-500-6480@WinstonPrepNJ

Transitions Program240 Madison Avenue, l4th flNew York, NY 10016646-869-4600@WPTransitions


CT APPLICATION for the 2019-2020 Academic Year

1 . APPLICANT INFORMATION

Preferred nickname (if any Date of birtLegal name ol applicant

Home adStrcet

City

Have you applied to WPS in the past? tr Yes

Current scho

Current grade-Applyingforgrade-Areyouinterestedinimmediateplacement?EYesflNo

state Zip code country

tr No lf yes, when did you apply?

School address TelephonCity State Zip Code

Former school(s): fro

fro

to

tofrom- to-

2. HOUSEHOLD INFORMAT]ONPlease complete the following information, as applicable.

HOUSEHOLD NO. 1

PARENT/GUARDIAN

Nam

Home address

PARENT/GUARDIAN

Name-Relationship to applicant_Home address

Home phon

Cell phon

Relationship to applica

Home

Cell phon

Email addres

0ccupation /Position-

Address

e

Email address_0ccu pa tion/Position-Company

Address

Business phonBusiness

College/Un iversi College/Un iversily-

(iiit www.winstonprep.edu


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I-ransitions Program240 Madison Avenue, l4th fl.New York, NY 10016646-869-4600@WPTra nsitions


Does the applicant live in a second househol

HOUSEHOLD NO. 2

PARENT/CUARDIANNamRelationship to applica nt

PARENT/GUARDIANNam e

Relationship to applica nt

Home address Home address

Home phon e HomeCell phonCell p

Email ad

CompAddBusiness phon e

College/Unive

Name(s) of sibling(s) age(s), and current school(

0ccupa tion/Position-Company

e

0ccu pation/Position-Email add

Ad

Business phon e

College/Universi

How did vou hear about Winston PreP?

tr Evaluator nD Advocate or nattorneY

ConsultantFriend or Familymember

tr SchoolD lnternettr Advertisementn Other

Please ela

3. MEDICAL AND TREATMENT INFORMATION1. Please list any allergies or health issues that require special attention.

Please list all of your child's current prescribed medications and dosages.

3. Hasyour child been diagnosed with any medical or mental health conditions? Please explain

2

i-,rl www.winstonPreP.edu


Y @WinstonPrep


Connecticut57 West Rocks RoadNorwalk, CT 06851203-229-O465@WinsionPrepCT

New Jersey901 Route 10 tastWhippany, NJ 07981973-500-6480@WinstonPrepNJ

Transitions Program240 l/adison AvenueNew York, NY 10016646-469-4600@WPTransitions

14th ft


4. OPEN HOUSE ATTENDANCEAttendance to an Open House is mandatory for prospective parents/guardians. During an Open House, you willhave the opportunity to hear more about our educational philosophy, tour the school, observe students and

classes and participate in a question and answer session. Please review the enclosed schedule and registeryourattendance.

Parents/Guardians required 0pen House dateDate ol Open House attendance

5. SIGNATUREThis application is a request for admission. This application for admissions becomes binding only when the student isevaluated, accepted, and you have delivered a fully signed Enrollment Agreement to Winston. Please complete, sign and

return this form with the $100.00 application fee and a cunent photograph of your child.

Parent or Guardian name (please print) Parent or Guardian Signature

Date

ADDITIONAL CONTACT(S): As signer of this application you are the primary point of contact for all admissions

communication. lf you wish to also designate your spouse or anyone else to receive direct communication, please indicate

their names and contact information below.

Preferred email and/or phone

Name Relationship

Preferred email and/or phone

The Winston Preparatory School admits students of any race to all the rights, privileges, programs, and activities generally accorded to studenls at thisschool. The sch6ol doei not discriminate on the basis of race, sex, religion, or national origins in the administration of education poiicies, athleticprograms, financial aid, payment plans, and other school administered programs.

Name: Relationship:

1,., 1 r4ww.winstonprep.edu


lt @WinstonPrep



New Jersey901 Route 10 EastWhippany, NJ 07981973-500-6480(OWinstonPrepNJ

Transitions Proqrarn240 Madison AvenueNew York, NY 10015646-469-4600@WPTransitions

14th ft.


To learn more about the Winston Prep Community,you are inMted to attend one of our Open Houses:

Friday morning, October 5th @ 9:50 am

Thursday evening, October 18th @ 6:00 pm

Tuesday morning, November 15th @ 9:30 am

Friday morning, November 30th @ 9:50 am

Friday morning,.fanuary 4th @ 9:50 am

Friday morning, Februarylst @ 9:50 am

Friday morning, March 1st @ 9:50 am

Thursday evening, March 21st @ 6:00 pm

Friday morning, April 5th @ 9:50 am

Friday morning, April 26th @ 9:50 am

Wednesday evening, May 15th @ 6:00 pm

Friday morning, June 7th @ 9:30 am

During our Open House you will have the opportunity to hear more about oureducational philosophy and tour our school.

Please RSVP through Wjnston Prep's website at www.winstonprep.edu/apply-now,or email Danje'lle Hawaux ([email protected]) your name, phone number

and planned date of attendance.

Please understand, attendance is limited to Parents & Professionals only

ir"rl www.winstonprep.edu


!f @WinstonPrep

New York126 West 17th StreetNew York, NY lOOll646-638-2705@WPSNY


New Jersey901 Route 1O tastWhippany, NJ 07981973-500-6480

Iransitions Program240 tiladison Avenue, 14th f l.New York, NY 10016646-869^4600@WPTransitions@Winston PrepNJ


PARENTAL STATEMENT

An understanding of each indiidualdives Wnston's educational program. ln keeping with thisspiit and philosophy, please thoughtfully share with us all that may be helpful in getting to knowyour child. Please attach responses on a separate page.

QUESTIONS:

1. Please describe your child, including strengths, weaknesses, personal relationships and interests

outside of school.

2. Please describe your child's school experience, including the circumstances sunounding theonset of school related difficulties.

3. ls your child cunently receiving support services (speech-language therapy, counseling,

tutorial) within or outside of their cunent academic setting? Please describe type and frequency

of service.

a. Why do you feel Winston Prep would be a good school for your child?

@ www.winstonprep.edu


| @WinstonPrep

New York'126 West 17th StreetNew York, NY 10011646-63A-2705@WPSNY

Co n necticut57 West Rocks RoadNorwalk, CT 06851203-229-O465@WinstonPrepCT


Transitions Program240 Madison AvenueNew York, NY 10016646-869-4600@WPTransitions

14th f t.

fl Winston Preparatory Schooleducotion for the individuol

TRANSCR]PT RELEASE

We require a transcipt of the cunent and the previous academic years. Please fill out the belowinformation and present this form to your chrld's current school. This form will authoize theschool to forward a copy ofyour child's transcipt and a teacher/counselor report to Winston'sAdmissions Office. The cunent school should mail the official school transcipt and reportsdirectly to Winston Preparatory School.

Present School

Address

I authorize you to send an official school transcript and a teacher or counselor report for

my child, , to

Circle 0ne

Winston PreparatorySchool CT

Office of Admissions57 West Rocks RoadNorwalk, CT 06851

Winston PreparatorySchool NJ

Office of Admissions901 Route 10 East

Whippany, NJ 07981

Winston PreparatorySchool NY

Office of Admissions126 West l Tth StreetNew York, NY 1001 I

Winston PreparatorySchool Ll

Office of Admissions30 Deforest Road

Dix Hills, NY 1 1746

I understand that the report is confidential between the sending school and WinstonPreparatory School.

Parent's Signature Date

(il,) www.winstonprep.edu


!| @WinstonPrep


Connecticut57 West Rocks RoadNorwalk, CT 06851203-229-O465@Winston PrepCT


'lransitions Progranr240 Madison Avenue, l4th flNew York, NY 10016646-869-4600@WPTransitions

Winston Preparatory Schooleducof ion for the individuol

TEACHER/SPECIALIST RECOMMENDATION FORM

Please have a current teacher, learning specialist, and/or counselor complete both pages and sendresponses directly to Winston Preparato4t School's Admissions Office.

Applicant Name:

Teacher/Specialist Nam

Winston Preparatory School is a co-ed day school for 4th through l2th grade students with learningdifferences such as dyslexia, nonverbal learning disabilities, expressive or receptive language disorders, andexecutive functioning difficulties. Our individualized educational program is based on an in-depthunderstanding of eaCh student's learning profile, with explicit skill and content instruction taught in-smallclasses averaging ten students each. Students are placed in class cohorts based on their learning profile,skill level, and social-emotional needs. lmportantly, students participate in a daily, one-to-one instructionalperiod, Focus, which serves as the diagnostic and instructional centerpiece of their experience.With tnls information in mind, please answer the following questions.

1. How long, and in what capacity, have you known the applicant?

2. Describe the applicant's academic strengths.

3. Describe the applicant's academic challenges.

4. Describe the applicant's level of engagement and social interactions on a typical day.

5. Describe an ideal classroom and school setting for the applicant.

6. Please provide any additional information we should know when making an enrollmentdecision.

(ii r) www.winstonprep.edu


lt @WinstonPrep

New York126 West lTth StreetNew York, NY 10011646-638-2705@WPSNY


New Jersey901 Route 1O EastWhippany, NJ 07981973-500-6480@WinstonPrepNJ

Transitions Program240 Madison Avenue, 14th flNew York, NY 10016646-869-4600@WPTransitions


Please rate the applicant on the following qualities, based on your current understanding.Ratings range from 1.0 (strongly dbagree) to 4.0 (strongf agree).

Student name: I 2 3 41. The student is consistently resilient.Comments:

2. The student is able to be a clear and direct communicator.Comments:

3. The student understands and consistently demonstrates the linkbetween effort and achievement.Comments:

4. The student is consistently an appropriate self-advocate (they ask forhelp and clarification).Comments:

5. The student is a consistently effective and helpful member of thecommunigl.Comments:

6. The student demonstrates regulation and selt-control consistentlyComments:

7. The student is reflective and self-aware.Comments:

B. The student is an adaptive, creative, and effective problem solver.Comments:

9. The student is consistently timely and organized.Comments:

Should the admissions office need additional information or clarification, I may be contacted at:

Phone ail

Signature: Date

(il) www.winstonprep.edu


!t @winstonPrep


Connecticut57 West Rocks RoadNorwalk, CT 06851203-229-O465@Winsion PrepCT

New Jersey901 Route i0 EastWhippany, NJ 07981973-500-6480@Winston PrepNJ



INFORMATION RELEASE FORMPlease complete, sign and retum this form with the application.

Full name of applicant:

I give authorization for the following professionals to provide any pertinent and confidential informationregarding my child's medical, psychological, and academic functioning with Winston Preparatory School, as

part of my child's application for admissions for the 2019-2020 school year. I understand that theinformation requested is for professional use and will remain confidential.

Signature of Parent / Guardian Date

Name of Parent / Guardian (please print)

School Principal/GuidanceCounselor

Name: Phone:

Email

Psychologist/Therapist

Name: Phone:

Email

Evaluator/Ed Consultant

Name: Phone:

Email

Attorney/AdvocateName: Phone:

Email:

Additional servicesnot listed above

Name: Phone:

Email:

@ www.winstonprep.edu


lf @WinstonPrep


Con necticut57 West Rocks RoadNorwalk, CT 06851203-229-O465@WinstonPrepCT

New Jersey9O1 Route 10 EastWhippany, NJ 07981973-500-6480@WinstonPrepNJ



TUITION AND FEES SCHEDULE

20 1 9 -2020 TUITI 0N : $68,500New and returning students are officially registered upon receipt of a sigmed contract and

deposit. Winston reseryes the right to terminate educational services for non-payment.

OPTI ONAL TUITI ON FINANCIN G

Your Tuition Solution 1 -BOO-920-9777Sallie Mae 1 -BBB-272-5543

FINANCIAL AID

Parents of students who have been accepted may apply for tuition assistance. Limited tuitionassistance is available. Requests are reviewed after a student is accepted into the program.

Winston receives no direct public funding, though many families pursue reimbursement underthe "Carter" mechanism. A decision on the award of financial aid may be delayed pending receiptof full information on available resources.

PUBLIC THIRD PARTY FINANCIAL ASSISTANCE

We expect payments to be made in accordance with our published tujtion and fee schedule. lt is

important to remember the "Carter" reimbursement mechanism is a legal and financial process

between families and their school districts. Winston Preparatory School has no direct financialrelationship with local school districts, and families should be mindful of this when pursuingthird party funding.

(ilit www.winstonprep.edu


!f @WinstonPrep



New Jersey901 Route l0 EastWhippany, NJ 07981973-500-6480@WinstonPrepNJ

fransitions Program240 Madison Avenue, l4th flNew York, NY 100i6646-869-4600@WPTransitions

Winston Preparatory Schooleducation for the individuol

Dr. Christopher BogartThe Southfield Center for Development85 Old Kings Highway NorthDarien, CT 06820(203) 202-76s4

Orit Batey Borkowski, Ph.D.55 Fawn RoadEaston, CT 06612(203) 4s9-0181

Michael S. Cohen, Ph.D., ABPP., LLC10 Wall StreetNorwalk, CT 06850(203) 4s6-2433

Jeanne C. Dietrich, Ph.D.550 Mamaroneck Avenue, Suite 102Harrison, NY 10528(914)381-6163

Marcia Eckerd, Ph.D.83 East Avenue, Suite 217Norwalk, CT 06851(203)299-1331

Marta Flaum, Ph.D.1 S Greeley Avenue, #2O3bChappaqua, NY 10514(914)238-1438

Jill S. Greenberg, Ph.D1B1 Post Road WestWestport, CT 06880(203) s05-8726

Recommended Neuropsvcholoeists & Evaluative SerMces

Tim Heitzman, Ph.D.1275 Post Road, Suite 202Fairfield, CT 06824(2O3) [email protected]

Carlyn Mccuffog, Ph.D., Ed.D., A.B.S.N.P.22 Westchester Avenue, Suite 406White Plains, NY 10604(917) [email protected]

Stephanie O'Leary, Psy.D.Westchester Psychologi cal Services91 Smith AvenueMt. Kisco, NY 10549845-313-9049

Raymond Psychological Services38 B Grove StreetRidgefield, CT 06877(203) 438-4OBO

Alexander Stone, Ph.D.26 Village Green, Suite 9, P.O. Box 552Bedford, NY 10506(914) [email protected]

Saasha Sutera, PhD583 Main StreetRidgefield, CT 06877(2O3)[email protected]

Sue Quinlan, Ph.D.68 Long Lots RoadWestport, CT 06880(2O3) 227-7661

(11,r www.winstonprep.edu


y @WinstonPrep




Transitions Program240 Madison Avenue, l4th fl.New York, NY 10016646-869-4600@WPTransitions


Lauren A. Baum, P.C.507 East 55'd Street, Suite 501New York, New York 10022Phone: (212) 644-4414Fax: (212) 644-8470

Nora Belanger, LLC161 East Avenue, Suite 104Norwalk, CT 06851Phone: (203)854-8597norabel [email protected]

Lawrence W. Berliner, Esq.1720 Post Road EastWestport, CT 06880Phone: (203)255-0582www.berlinerspecial edl aw.com

Meredith Braxton, Esq.280 Railroad Ave. #205Creenwich, CT 06830Phone: (2O3)661-4610

Jill Chuckas, MSWCT Education Advocacy195 Minivale RoadStamford, CT 06907Phone: (203) [email protected]

Rec omm en d ed C onn ecti cu t Advo cates /Attorn eys

Phillip J. Cohn, PartnerGoldman Cruder & Woods, LLC200 Connecticut AvenueNorwalk, CT 06854

120 White Plains RoadSuite 505Tarrytown, NY 10591

Phone: (2O3)[email protected]

Andrew Feinstein, Esq.Feinstein Education Law Group86 Denison AvenueMystic, CT 06555

Satellite: 945 Main Street, Suite 504Manchester, Connecticut 06040

Phone: 860-572-8585 or860-969-0700 Direct Ext. 100www.attorn eyfein stein. com

Ceraldine P. Fleming, LLCSpecial Education Advocate161 East Avenue, Suite 104Norwalk, CT 06851Phone: (203) 543-6500gerri.fl [email protected]

Winston provides the following list of attorneys who have represented Winston parents in the past for your information. Pleaseevaluate the credentials and capabilities of any attorney you may wish to engage to represent you.

tiiit www.winstonprep.edu


lt @WinstonPrep


Connecticut57 West Rocks RoadNorwalk, CT 0685i203-229-O465@WinstonPrepCT

New Jersey901 Route 10 EastWhippany, NJ 07981973-s00-6480@WinstonPrepNJ

Transitions Program240 Madison Avenue, l4th fl.New York, NY 10016646-869-4600@'WPTransitions


Vicki LePage (Advocacy)Parenting Coach, [nc.Phone: (914)[email protected]

Jennifer Laviano, LLC76 Route 57 SouthSherman, CT 06784Phone: (860) [email protected]

.famie Mattice, Esq.P.O. Box 116

Brookfield, CT 06804Phone: (203) 802-7OO2j amie@jmatticel aw.com

*Licensed in both CT & NY

Cerry McMahon, Esq.Law Offices of Cerry McMahon, LLCTwo Overhill RoadScarsdale, NY 10585Phone: (866) 535-4604www.attorneyspecial educationctny.com

Piper Paul, Esq.Ooldman, Cruder & Woods, LLC200 Connecticut AveNorwalk, CT 06854Phone: 205-899-8900ppaul@goldmangru d erwood s.com

165 West Putnam AvenueOreenwich, CT 06850Phone: 203-983-6767

105 Technology DriveTrumbull, CT 06611Phone: 203-880-5333

Courtney P. Spencer, Esq.100 Riverview Center, Suite 120Middletown , CT,06457Phone: (860) 450-5380courtn ey@courtn eyspen cerl aw. com

98 Mill Plain RoadSuite 3BDanbury, CT 06811Phone: (866)783-1073

Bonnie Spiro Schinagle, Esq.19 West 54th Street, PenthouseNew York, NY 10001Phone: (516) 587-5874bschina gle@schinagl el aw.comwww.schinaglelaw.com

Noreen O'Mahoney, S.D.A. (CollaborativeAdvocacy Associates)191 Post Road WestWestport, CT 06880Phone: (2O3) [email protected]

Tracey Spencer Walsh, Esq.579 West BroadwayNew York, NY 10012Phone: (212) [email protected]\il.spen cerwal shl aw.com

Winston provides the following list of attorneys who have represented Winston parents in the past for your information. Pleaseevaluate the credentials and capabilities of any attorney you may wish to engage to represent you.

1ii) www.winstonprep.edu


t/ @WinstonPrep

New York126 West 17th StreetNew York, NY 10011646-638-2705@)WPSNY


New Jersey901 Route 10 EastWhippany, NJ 07981973-500-6480@Winston PrepNJ

Transitions Program240 Madison Avenue, l4th fl.New York, NY 10016646-A69-4500@WPTransitions

q/tj'/lry€¦ · the cunent school should mail the official school transcipt and reports...

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