RWM APPLICATION - Spring Break 2026

Read/Write & Math Intervention

Spring Break Program Application
Application Requirements
Before you begin this application, please ensure you have all required documents:
1. This application form
2. Psychoeducational assessment (for any child with diagnoses)
3. Most recent report card
4. Bursary application and supporting documents (if applicable)
Program Registration Guide
I have reviewed and agree to adhere to the Program Registration Guide

Parent Information
Parent / Legal Guardian #1 (all legal parent/guardians must be listed):*

First NameLast Name
Phone Number*
Email*
Parent / Legal Guardian #2 (all legal parent/guardians must be listed):

First NameLast Name
Phone Number
Email
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Student Information
Student Legal Name*

First NameLast Name
Student Date Of Birth*

MonthDayYear
School*
Grade*
Read/Write & Math Intervention requires submission of the most recent report card. If your child is homeschooled, learning plans are required. Please upload here. *

Cancelof
YesNo
Student Learning Profile
ADHDReading Learning DisabilityWriting Learning DisabilityMath Learning DisabilityOther Diagnosis
Read/Write & Math Intervention requires documentation supporting any diagnosis. All applications for students with a diagnosis must include submission of a psychoeducational assessment. Please upload here.

Cancelof
Read/Write & Math Intervention programs provide structured, remedial and intervention-based programming. Please identify the concerns you have with your child's literacy and/or numeracy skills. DO NOT include instructor preferences or requests. *
Program Selection
LiteracyNumeracy
8:30AM-10:30AM11:00AM-1:00PM1:30PM-3:30PM
In person at Foothills AcademyOnline
Bursary Program
Bursary Application Form
YesNo
I have an active bursary application on fileI have emailed a new bursary application
Dave Bolink, Director of Business Management
dbolink@foothillsacademy.org 403-270-9400 ext.214
YesNo
Should be Empty:

Read/Write & Math Intervention

Application Requirements

Parent Information

Student Information

Student Learning Profile

Program Selection

Bursary Program