Apply Now – Junior Academy

Please fill out this form and submit it to Junior Academy before your Child’s classroom visit. Please fill out one form per child.

Present School *

Name of Child *

First

Last

Grade applying for *

Possible Start Date *

Birth Date *

Please indicate any of the following if your child has had a(n):

Psycho-educational assessment
IEP (individualized education plan)
Other support. Please describe:

Other support description

Failure to disclose this information may result in Junior Academy being unable to support your child.

Parent #1's Name *

First

Last

Contact Phone Number *

Email *

Occupation *

Home Address *

Parent #2's Name

First

Last

Contact Phone Number

Occupation

Home Address

Upon your visit, please provide us with copies of your child’s last two June report cards as well as any additional relevant reports prior to their visit. It is helpful to have a photo of your child as well.

A non-refundable application fee of $100 must be paid the day of the Child Assessment.

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