RW APPLICATION FALL 2023

Read/Write WAITLIST Application
Thank you for your interest in our Read/Write programs. For information on programs, please visit our website by clicking HERE

Please reach out to us at rwmintake@foothillsacademy.org with any questions you may have.

The programs we offer are: Intensive Literacy, Weekly Literacy, and Literacy Booster

We are still actively registering students in intensive programs and literacy boosters but our weekly literacy programs are full.

While completing the application you will be asked to select which program you are interested in. You will not be able to see the other program information to apply. If you are interested in multiple programs please use the preferences box to indicate any other programs you are interested in.

For example: You are completing this application for Weekly Literacy but are also interested in registering your child for a Literacy Booster, you can select Weekly Literacy as your program option and then in the question asking preferences, type that you are also interested in a Literacy Booster and what times/dates you are interested in.

Please DO NOT submit multiple applications. Simply list everything you want in the box provided.

Student Info
Child's Legal Name*

First NameLast Name
Child's Date Of Birth*

MonthDayYear
Parent/Guardian Name*

First NameLast Name
Email*
Phone Number*
Has the student been previously enrolled in any Read/Write Math programs?*

YesNo
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Student Info
Child's Preferred Name
Grade*
School*
Student's first language:*
Spoken at school (majority of classes):
Spoken at home (most often):
What diagnoses does the student have? (select all applicable)*

ADHDMath Learning DisabilityReading Learning DisabilityWriting Learning DisabilityOther
What are some of your child's interests?*
Please identify the top 3 concerns you currently have with your child's literacy skills (your child's instructor will use this information to help create program goals - the more information provided the better):*
Do you have any suggested academic or behavioural strategies for your child's instructor? *
Are there any potential triggers (fears/phobias/anxieties) or current difficulties in the family (i.e. family member's health, recent death) that may affect your child at our program?*
If your child has applied or completed the intake process for other Foothills Academy programs, please sign below to provide consent to access your child's file. We may access their file to obtain a copy of their psycho-educational assessment or IPP. Programs Include: Psychology Groups, Amicus Camps and Recreation, Foothills Academy School Program

*Please note if your child has completed a psycho-educational assessment through Foothills Academy Community Services, we cannot obtain their assessment without parent completion of a Authorization to Release Information form. Please reach out to rwmintake@foothillsacademy.org if you need to complete this form in order for us to obtain the psych-ed assessment internally.
Sign here to provide consent to access your child's file from the above programs:

Clear
Please upload your child's most recent report card. If not submitted, we will follow up to request this. If you submitted a report card for the Summer or Fall 2022 semester, we will have it on file and you do not need to resubmit.

Cancelof

Program Selection
The student would attend this course:*
If there is no more availability for your preferred selection, would you accept a spot offered in the alternative facilitation method (i.e. no more available in person spots, would accept online spot)?*

YesNo
Which program would you like to apply for?

LiteracyMath

Which literacy program would you like to apply for?

Literacy BoosterWeekly LiteracyLiteracy Intensive

Which math program would you like to apply for?

Weekly MathMath Booster

WEEKLY LITERACY PROGRAM OPTIONS

Weekly literacy is offered 1-2 hours per day M-S. While we do offer multiple weekly lessons we cannot guarantee availability for all those interested in more than one lesson per week. We do our best to accommodate all requests received for days, times, total hours, and instructors.

To apply for a weekly literacy program:
Pricing:

1. Input the total hours per week you would like your child to attend

2. Select the days and times that your child is available. Times are broken into Morning, Afternoon, and Evening selections.

3. If you have preferences for the days and times you have selected, please enter them in the text box.

4. If you have a specific instructor you would like to request, please enter their name in the text box.
Monday Weekly Literacy: 13 lessons ($780 for 1 hr/lesson; $1560 for 2hr/lesson)

Tuesday Weekly Literacy: 13 lessons ($780 for 1 hr/lesson; $1560 for 2hr/lesson)

Wednesday Weekly Literacy: 14 lessons ($840 for 1 hr/lesson; $1680 for 2hr/lesson)

Thursday Weekly Literacy: 14 lessons ($840 for 1 hr/lesson; $1680 for 2hr/lesson)

Friday Weekly Literacy: 11 lessons ($660 for 1 hr/lesson; $1320 for 2hr/lesson)

Saturdays Weekly Literacy: 11 lessons ($660 for 1 hr/lesson; $1320 for 2hr/lesson)

Weekly Literacy Spot Limitations: Weekly literacy programs remain in high demand and we do our best to accommodate every application we receive. Please note that our Weekly Literacy programs fill very quickly after applications open. Should program spots fill before your application is received, our Intake Coordinator will reach out to confirm your child has been put on the waitlist.
How many hours total per week would you like to request?

Days and Morning Times for Weekly Lessons (Monday - Saturday)

	Morning Times
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday

Days and Afternoon Times for Weekly Lessons (Monday - Saturday)

	Afternoon Times
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday

Days and Evening Times for Weekly Lessons (Monday - Friday)

	Evening Times
Monday
Tuesday
Wednesday
Thursday
Friday

Please indicate any preferences for lessons below. (Please include all program requests)
If you would like to request a specific instructor, please enter their name below.

Booster Literacy Program

Do you find committing to 4-5 consecutive weeks too difficult? Does your student need daily repetition for growth?

Our 1-week boosters are a wonderful alternative to weekly lessons to fill in specific gaps in literacy skills. Get the same number of hours in one week that you would in 3 months coming once a week. Using the same evidence-based literacy programs, our instructors informally assess your child on the first day of the program and develop literacy goals for the week of the program. Choosing a Booster is the next best choice for an Intensive program. Evidence shows daily repetition inspires more growth than once a week.

Please refer to the program information below to see any upcoming Literacy Booster Weeks we are offering.

Fall 2023 Program
Week Long Booster Options:

8-Hour weeks: Monday-Thursday (2 hours per day)

10- Hour weeks: Monday-Friday (2 hours per day)

12-Hour weeks: Monday-Friday (3 hours per day)

15-Hour weeks: Monday-Friday (3hours per day)

NO LESSONS ON: September 29, 30, October 7, 9, 27, 28, 31, November 10, 11

Please select a week that is your first choice below and then list any other weeks in the box provided.
How many weeks are you hoping to book?

123
What date do you want to start?

MonthDayYear
Date
Do you prefer 2 or 3 hours per day?

2 (for a total of 8 or 10 hours)3 (for a total of 12 or 15 hours)
Please indicate your scheduling preferences here (include preferred start date and time) Example Monday April 17, 8:00am or 8:30 am:

WEEKLY MATH PROGRAM OPTIONS

Weekly math is offered 1 hour per day M-F. While we do offer multiple weekly lessons we cannot guarantee availability for all those interested in more than one lesson per week. We do our best to accommodate all requests received for days, times, total hours, and instructors.

To apply for a weekly math program:

Pricing:

1. Input total hours per week you would like your child to attend

2. Select the days and times that your child is available for. Times are broken into Morning, Afternoon, and Evening selections.

3. If you have preferences for the days and times you have selected, please enter them in the text box.

4. If you have a specific instructor you would like to request, please enter their name in the text box.

Monday Weekly Math: $600.00 for 10 lessons

Tuesday Weekly Math: $660.00 for 11 lessons

Wednesday Weekly Math: $660.00 for 11 lessons

Thursday Weekly Math: $660.00 for 11 lessons

Friday Weekly Math: $600.00 for 10 lessons

Saturdays Weekly Math: $600.00 for 10 lessons

Weekly Math Spot Limitations: Weekly math programs remain in high demand and we do our best to accommodate every application we receive. Please note that our Weekly Math programs fill very quickly after applications open. Should program spots fill before your application is received, our Intake Coordinator will reach out to confirm your child has been put on the waitlist.

How many hours total per week would you like to request?

Days and Morning Times for Weekly Lessons (Monday - Saturday)

	Morning Times
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday

Days and Afternoon Times for Weekly Lessons (Monday - Friday)

	Afternoon Times
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday

Please indicate any preferences for lessons below.

Days and Evening Times for Weekly Lessons (Monday - Friday)

	Evening Times
Monday
Tuesday
Wednesday
Thursday
Friday

MATH BOOSTER PROGRAM OPTIONS

Booster weeks run 4 days or 5 days per week. This option is available year round for families looking for a flexible option to have a student attend daily for one week. Programs are either 2 or 3 hours per day for 4 or 5 days.

Booster weeks start on Mondays.

Choose from one, two, three, or four weeks. If selecting four weeks, this is part of an intensive program.

Please indicate your preferred start date, times, and indicate if you have any flexibility with your start date or time.

Boosters are only offered between 8:00am-4:00pm Monday-Friday.

Booster weeks are a wonderful way to get the same amount of instruction in one week as a student gets in one session of weekly lessons. Instructors develop a specific targeted goal and work with the student to build confidence and achieve that goal.
Please indicate your scheduling preferences here (include preferred start date and time) Example September 11, 8:00am or 8:30 am:

Bursary Request
Bursary - I would like to apply for financial assistance for this program through Foothills Academy. (Please note that while the bursary program is not restricted to low income families, an application outlining the need for fee reduction will be sent to you and will require tax documentation).

NoYes
Should be Empty:

Read/Write WAITLIST Application

Student Info

Student Info

Program Selection

Bursary Request