POINT IDS Weekly and Intensive RW APPLICATION

Read/Write 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

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.

Parent/Guardian Info
Parent/Guardian Name*

First NameLast Name
Email*
Phone Number*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Student Info
Student Legal Name*

First NameLast Name
Student Preferred Name
First Name
Date Of Birth*

MonthDayYear
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
Has the student been previously enrolled in any Read/Write Math programs?*

YesNo
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 you have previously submit one for the current school year, you do not need to resubmit the report card. You may also choose to upload a psycho-educational assessment, IPP, or any other supporting documentation that may assist our team with best understanding your child's current literacy strengths and challenges.

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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?*

Weekly LiteracyIntensive LiteracyLiteracy Booster

Which math program would you like to apply for?

Weekly MathMath Booster

WEEKLY LITERACY PROGRAM OPTIONS

Weekly literacy 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 literacy 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.

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.

If you are looking for Saturdays, please know there are NO spaces available. Saturdays are now full.

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 - Friday)

	Morning Times
Monday
Tuesday
Wednesday
Thursday
Friday

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

	Afternoon Times
Monday
Tuesday
Wednesday
Thursday
Friday

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

	Evening Times
Monday
Tuesday
Wednesday
Thursday
Friday

Please indicate any preferences for lessons below. If you are also interested in a Literacy Booster or Intensive program, please indicate that interest here and list what times and dates you are hoping to register for.
If you would like to request a specific instructor, please enter their name below.

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 Application

Parent/Guardian Info

Student Info

Program Selection

Bursary Request