Name: Interview Request Form
SKU: 11354
Availability: InStock

First Name *

Last Name *

Year Applying For *

Grade Applying For *

Birth Date (dd/mm/yyyy) *

Diagnosis of dyslexia
or learning disability by
a doctor or psychologist *

Yes

No

Child lives with *

Single Parent

Both Parents

Guardian

Allergies

Medication

Home Address

Section

Student First Name *

Student Last Name *

Home Address *

Home Address

Section

If available, please upload, or mail us the following:

3 most recent report cards, including two most recent year-end reports
Individual Education Plan (IEP)
IPRC Information
OT and SLP assessments
Psycho-educational assessment

File Upload

Maximum file size: 20MB

Parents' Information

Parent 1

First Name *

Last Name *

Parent 1 Address *

Parent 1 Address

Home Phone

Cell Phone *

Work Phone

Email *

Confirm Email *

Occupation *

Employer *

Parent 2

First Name

Last Name

Parent 2 Address

Home Phone

Cell Phone

Work Phone

Email

Confirm Email

Occupation

Employer

School Application Terms & Conditions

Applications are invited for students with dyslexia experiencing difficulties in Reading, Writing, and Math, diagnosed with Learning Disorders in Reading, Writing and Math:

Application to Claremont School is not a guarantee of acceptance.
The process involves an interview with one or more teachers, including the principal or principal designate; a school visit; review of school report cards and teacher referral form, IEP and psycho-educational assessment.
In addition to #2, we may ask to speak with your child’s teacher or teachers.
The school visit may be 1 – 3 days, in person or online if in-person visits are not allowed due to government or TPH restrictions.
Only after all the data has been collected and discussed by the Admissions Committee will acceptance be considered. This process may take weeks or months depending on when the application was received, prior applications and
If there are no spaces available, you will have the choice of an application fee refund or you may proceed with your application and be placed on the waiting list for the following year or the next available opening.
Application fees are non-refundable, with the exception listed in #6.

Terms and Conditions agreement

I agree to the above terms and conditions

I am paying the Application Fee of CAD$350

Online

Credit Card *

Parent 1 address details are being used for the credit card

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