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Inquiry Form

Thank you for your interest in our school! 

Please fill out this inquiry form if you would like more information regarding our school, scheduling a tour or a phone conversation.  We look forward to learning more about you and your child. 

Kindly,

The Epiphany School of Charlotte Leadership Team

* Indicates a required field.

Parent / Guardian Information
  • First Parent / Guardian
  • First Name *
  • Last Name *
  • Salutation
  • Email Address *
  • Confirm Email Address *
  • Gender
  • Cell Phone
  • Second Parent / Guardian
    (leave blank if not applicable)
  • First Name *
  • Last Name *
  • Salutation
  • Email Address *
  • Confirm Email Address *
  • Gender
  • Cell Phone
Home Address
  • Street Address
  • City
  • Country
  • State
  • Zip
  • Home Phone
  • How Did You Hear About Us? *
    Details:

  • Would you like to schedule a tour?
    * Yes   No

  • How quickly are you looking to make a change to current situation?
    *

  • Exceptionality:
    *

  • Is your child able to be verbally redirected and respond with verbal communication?
    * Yes   No

  • Does your child require 1-on-1 support?  Epiphany cannot offer 1-on-1 classroom support.
    * Yes   No

  • If other, please list.

  • Interventions:
    *

  • If other, please list.

  • Academics:  Students at Epiphany typically perform around grade level for math and lanugage arts subjects.  Does your child perform at, above or below grade level?  If below or above, please describe the difference in years.  Example, "my child is in 4th grade but performs at a 6th grade level in math" or "my child is in 7th grade but performs at a 3rd grade level in reading".  We are keenly aware of children's struggles in the classroom in relation to a social communication difference, a learning disability, or an extenuating emotional factor.  We take all information into account when reviewing our school with you as a potential academic fit.
    *

  • Major Concerns:  Please describe the major concerns you have for your child in the school setting, and what expectations you might have of a school in order to offer appropriate support to your child?
    *

  • Are you aware of the North Carolina Grants that could assist your child in receiving services and schooling?  If no, learn more at www.ncseaa.edu.  
    * Yes   No
  •  
  • Student 1
  • First Name *
    Last Name *
  • Birthdate *
    (mm/dd/yyyy)
    Gender
  • Grade Level of Interest *
    School Year *
  • Current School
  •  
  • Is There Another Student?
    Yes No
  •  
  • Parent / Guardian Notes
  •