RWM APPLICATION

Read/Write & Math Intervention Program SPRING 2025 Program Application
Thank you for your interest in our Read/Write & Math Intervention programs. For information on programs, please visit our website by clicking HERE

Please note, the title of our department is Read/Write & Math Intervention. This does NOT mean all programs blend literacy and numeracy. You may choose to request a blended program in boosters and/or intensives only. We will assess and determine if doing both programs is the best intervention for your child. Our interventions are based on assessment and not request.

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

We require documentation supporting any diagnosis. If your child has NOT been diagnosed, please do not check off a diagnosis. You can tell us your concerns for your child in the space provided.

PLEASE NOTE: All applications require a January report card. Report cards were released on January 27 in the CBE and earlier or later the following week for all other boards. Applications will NOT be processed without the most current progress report.

If your child is accepted into a program (or is already in a program) we use Hubshare to communicate with families. You will get an invitation to create an account with Hubshare. If you already have an account, you can access it here: ca.hubshare.com

We are offering:

Weekly Lessons in Literacy OR Math (1 or 2 hours per lesson, once a week) Cost: $70/hour; Hours: Monday-Thursday 4:00-7:30; Fridays 12:00-7:30; Saturdays 8:30-5:15. If you choose math, we STRONGLY recommend your child attends twice per week.

Booster Weeks (Literacy or Math) (2-3 hours per lesson, 4-5 lessons in one week during the school day only) Cost: $65/hour; Hours are between 8:00AM-3:30PM M-F

Intensives (Literacy or Math) (2-3 hours per lesson, 4-5 lessons per week, 4-5 weeks during the school day only) Cost: $65/hour plus mandatory pre- and post-assessment $480; Hours are between 8:00AM-3:30PM

Foundations in Math Small Group: 2 lessons per week; Group is 2-5 students; One instructor; Uses ST Math, manipulatives, direct instruction, and builds foundational skills. Option to select topics relevant to current school work.

All programs have weekly updates loaded into your parent account in Hubshare.

All programs are with the same instructor barring any unforeseen challenges or illnesses when we provide a sub. There are NO CANCELLATIONS and NO RESCHEDULING of lessons for any reason unless we are unable to provide you with a sub.

Registration is first come first served. Please indicate ONLY THE TIMES YOU ARE AVAILABLE.

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) PLEASE NOTE: If you select a diagnosis, we require documentation supporting that diagnosis before you are given a space in the program. Please upload supporting documentation with this application. Do NOT check a diagnosis if your child does not have a psychoeducational assessment.

ADHDMath Learning DisabilityReading Learning DisabilityWriting Learning DisabilityNo Diagnosed Learning DisabilityOther
Tell us some your child's interests.*
Foothills Academy Society is one of the only programs that offers financial relief to make it easier for students who need support to get the help they need. We rely on fundraising and donations to make this happen. Are you interested in learning about our fundraising efforts?

YesNo
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):*
I have read the cancellation policy and understand I have to pay a non-refundable deposit of $100 to secure my child's spot when offered a program placement (Initial)*

Yes
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. You may choose to update the report card through Hubshare when you have a new one to share.

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?*

LiteracyMathBoth

Which program would you like to apply for?*

Booster (Literacy or Math)Weekly (Literacy or Math)Intensive (Literacy OR Math OR Blended (determined by assessment if requested)Foundations in Math Small GroupSpring Break BoosterMore than one program
Which math program would you like to apply for?

Weekly MathMath Booster

Booster Program

Our 1-week boosters are a more effective option than 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.

Boosters take place during the school day between 8am-4pm. These are school pull-out programs.

Booster weeks start on Mondays and run either 4 or 5 days (Monday-Thursday or Monday-Friday).

Boosters cost: $650 for 10 hours (5 days) or $975 for 15 hours (5 days) or 12 hours (4 days) $780 or 8 hours (4 days) $520

Rolling Intake. Please tell us what Monday you want to start. Starting March 31 and every Monday after.
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?

23
Tell us: Literacy or Math? Please note: the time is too short to offer both literacy and math to get meaningful results.

FOUNDATIONS IN MATH SMALL GROUP PROGRAM

Small group program. 4-5 students in each spot. We require a minimum of 2 students for the group to run.

Required to attend twice per week.

Students work on foundational skills to support their work in the classroom. Working with an experienced instructor, students will work on math vocabulary, calculation strategies, word problems, and learn foundational strategies like: Chisanbop, Woodin Math, and Visualization.

Choose from two days between M-Th (ex. Monday and Tuesday, or Monday and Wednesday, or Tuesday and Thursday, or Wednesday and Thursday)

Session 1: 4:00-4:50pm

Session 2: 5:00-5:50pm

Session 3: 6:00-6:50pm

Choose from 5 weeks (10 lessons) or 10 weeks (20 lessons). Each set of 5 weeks is $450. Cost for all ten weeks is $900.

Upon approval of your application, we will send you a link to choose your days and times.
I would like to book:*

5 weeks10 weeks

Spring Break Literacy OR Math Booster

Worried about your child's literacy or math skills and do not have plans to be away? Are you looking for a boost over the winter break? Come join us for 4 days or two days to get a boost and some insight into what your child needs to work on during the Winter semester. We have limited spaces available for this great opportunity.
I would like to register my student in:

5 day booster, 2 hours per day (March 24-28) 10 hours: $6505 day booster, 3 hours per day (March 24-28) 15 hours: $975
I prefer:

MorningsAfternoons
I am requesting:

LiteracyMath
I would like to register my child in the Foundations in Math Small Group SPRING BREAK March 24-28 program *Families must choose 5 lessons however, they can stack them on a particular day or choose different times that might work better for them

Yes and I understand I will receive a registration link to choose my days and times
I am interested in a full day option with a camp portion (games and activities)

YesNo
Please provide us with any other information you wish to share

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 & Math Intervention Program SPRING 2025 Program Application

Student Info

Student Info

Program Selection

Spring Break Literacy OR Math Booster

Bursary Request