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Thank you for your interest in Green Oaks Education and Support, Inc. 

Please fill out the form below and someone from Green Oaks will contact you. You may also call us at 817-861-5000.

* Indicates a required field.

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

  • Relationship to student:
    *

  • Have you visited Green Oaks?
    Yes   No

  • If so, when?
    (mm/dd/yyyy)
  •  
  • Student 1
  • First Name *
    Middle Name
    Last Name *
  • Birthdate *
    (mm/dd/yyyy)
    Gender *
  • Email Address
    Confirm Email Address
  • Grade Level of Interest *
    School Year *
  • Current School

  • Diagnosis/Disability:
    *

  • We seek to provide the best educational program for most individuals with an intellectual disability. As such, our program is not for everyone. We will carefully work with families to determine appropriateness of the program for the student and of the student for the program. Please read the following Admissions Criteria then click yes. If you have any comments or concerns about the Admissions Criteria, you may add those in the Notes section below.

    1. Students must be turning five by January of the current school year. There is no upper age limit for GOAL.
    2. Students must be free from significant medical or physical concerns.
    3. All students are to be completely and independently toilet trained, unless a very specific conversation is held with a Director. (Exceptions may be considered for students under seven years old.)
    4. Students must be free from significant behavior concerns. Students demonstrating behaviors that are harmful or disruptive to the Green Oaks community will not be admitted and may be dismissed if behaviors emerge after acceptance.
    5. Students are expected to fit the program we offer. Those who may require significant modification of the program, or those for whom Green Oaks is not suitable, will be referred to other programs or schools whenever possible.
    * Yes   No
  •  
  • Is There Another Student?
    Yes No
  •  
  • Parent / Guardian Notes
  •