St. Joseph Program Application

Welcome to the St. Joseph Program. Please submit the application form below and provide completed educational testing that is no more than 3 years old.

This evaluation should be completed by a professional psychologist or school IEP team. Upon completion of the application, you will be contacted to participate in a family meeting with members of the St. Joseph Program staff to review testing, accommodations, and appropriateness of placement in the program. If it is determined that the school can meet the needs of your student, an Individualized Accommodation Plan (IAP) will be designed. The plan will then be reviewed with the family.

The St. Joseph Program Director and Learning Specialist are available to provide any information families may need throughout the application process.

Contact info:
Mrs. Kelly Roiy
St. Joseph Program Director
kroiy@johncarroll.org
410.838.8333 x4045

Student Name

Graduation Year

Phone

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Previous School Attended

Parent(s) Names

Reason for Application

Most recent testing

Completed by a public school team

Completed by a private psychologist

Date testing was completed

Person(s) completing testing

Accommodations being utilized at this time

What do you see as your child’s strengths?

What do you see as your child’s areas of need?

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St. Joseph Program Application

Welcome to the St. Joseph Program. Please submit the application form below and provide completed educational testing that is no more than 3 years old.