Summer 2025 - Adaptive Assistance Request Form

Summer 2025 - Adaptive Assistance Request Form

Arts for All at Follow Your Art Community Studios
Our Arts for All program makes every effort within its resources to work with each student's needs to offer individualized adaptive assistance.

Arts for All can offer adaptive assistance for persons with disabilities (learning, physical), persons with mental health needs, persons with some medical needs, and/or persons who require translation services. This can look like making appropriate curricular and/or space accommodations or modifications, or hiring an assistant to provide individualized aid, to name a few.

Filling out this form will help us better understand how to support each student in accessing programs at FYACS.

After filling out this application, our Arts for All Coordinator will be in touch to discuss recommend programming and supports.
Caregiver Information

Information of the caregiver applying for tuition assistance on behalf of the summer 2025 student.
Caregiver Name*

First NameLast Name
Date of Birth*

MonthDayYear
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Preferred mode of communication (check all that apply)

EmailPhone
Caregiver Relationship to Student*

ParentLegal guardianOther relativeGroup home contactOther
Student Information

Information on the student(s) hoping to participate in FYACS Summer programming.
Name of Student*
Date of Birth of Student*

MonthDayYear
Date
In order to help us identify what kinds of support (medical, cognitive, behavioral, physical, emotional) we can put in place, please describe the needs and diagnoses of the student.*
Our Arts for All Coordinator will follow up with you to discuss how to best support the student in attending programs at FYACS.
Please describe the types of adaptive assistance that would best serve the student(s).
For a student requesting physical, cognitive, behavioral, or emotional support: What systems or procedures help the student succeed in a creative learning environment? (For example: Is there specific language that helps in communication? Does the student use an assistive device? Would the student benefit from an interpreter? Are there physical adaptations to our space that would help?) If the student is receiving assistive services elsewhere, what are they?
Our Arts for All Coordinator will follow up with you to discuss how to best support the student in attending programs at FYACS.
Would the student benefit from having a 1-1 aid to participate in a class? Please explain.*
Our Arts for All Coordinator will follow up with you to discuss how to best support the student in attending programs at FYACS.
For students looking for medical support: We do not have a full-time nurse on staff. If your child requires medical support, please specify so we can look into potentially supporting you.
If there is any other information that would help us support the student, please include it here.
Our Arts for All Coordinator will follow up with you to discuss how to best support the student in attending programs at FYACS.
Are you also looking for financial assistance at this time?

YesNo
If you require financial assistance for Summer 2025 programming for your child, please complete this form.
How did you find out about the Arts for All Program?

FacebookInstagramCard to Culture Program Listing on mass.govFollow Your Art Community Studios websitePostcardMelrose Public Schools Virtual BackpackWord of mouthOther
Is there anything else you would like to share with us?
Questions?

Email: artsforall@fyamelrose.org

Phone: (781) 665 4140

Arts for All Office Hours: Tuesdays 9AM-12PM & Thursdays 12PM-2PM
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Summer 2025 - Adaptive Assistance Request Form

Caregiver Information

Student Information

Please describe the types of adaptive assistance that would best serve the student(s).