Application form – Child

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Application Form - Child

Notes:

1. Applications for admission and enrollment in the online programs are considered year-round. You can start Interactive Metronome®  at any time during the current month. For all other programs, the admission process must be completed, including payment, at least 3 working days before the end of the current month, in order to start the intervention at the beginning if the next month.

2. Applications for in-person admission and enrollment are considered in May-June (or earlier) each year for the upcoming academic year September-July.

3. Submitted applications do not imply immediate admission, irrespective of whether in-person or online enrollment is concerned. Your application will be considered. In case the selected program is appropriate for the candidate and there are available spots, you will be contacted, in order to proceed with the admission process. The admission process is not completed, unless you receive a formal confirmation of the enrollment.

4. Submitted applications will be considered for admission on first-cum-first-serve basis.

5. During the admission process, you might be required to provide relevant documents.

6. It is best if the parent completing the application form is the parent who will be mainly assisting the child in the home intervention program and communicating with the professional team. All online and in-person programs include obligatory homework, in order for the acquired knowledge and skills to be stabilized, automatized and generalized.

    Information about the child who will be enrolled in the chosen program:

    Name
    Age
    Date of birth
    City and country of residence
    Mother tongue
    Languages the child is exposed to, besides their mother tongue
    Is the child enrolled in kindergarten or school?
    [group answer-yes clear_on_hide] [/group] [group kindergarten-yes clear_on_hide] [/group] [group school-yes clear_on_hide] [/group]
    Does the child have a formal diagnosis?
    [group diagnosis-yes clear_on_hide] [/group]
    Main complaints
    a. b. d. d. e.
    Previous evaluations
    [group evaluations-yes clear_on_hide] [/group]
    Previous interventions
    [group interventions-yes clear_on_hide]
    Speech & Language Therapy
    Special Education
    Psychologist
    Behavioural Therapy
    Occupational Therapy
    Sensory Integration Therapy
    Neuromodulation
    Medication
    Other
    [/group]
    Other relevant information about the child

    Information about the parent, applying for the child

    Name
    Educational qualification
    Occupation
    Email address
    Mobile phone number
    Preferred form of communication
    [group communication-mobile-app clear_on_hide][/group] [group communication-other clear_on_hide][/group]
    How much time per day are you able to spend working with the child on the home program? (All online and in-person programs include obligatory homework, in order for the acquired knowledge and skills to be stabilized, automatized and generalized.)
    I would like my child to be enrolled in
    How did you learn about us?