Intervention Programme Application Form

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Please complete the form and we will be in touch with you.

Name (Parent) *

Phone Number *

Email *

Student Name *

Do you attend Choice Christian Academy? *

Yes

Student Current Grade Level *

Grade 1

Grade 2

Grade 3

Grade 4

Grade 5

Grade 6

Student D.O.B *

YYYY

Have you done a psycho-educational assessment? *

Yes

How would you like your follow-up consultation done? *

Phone Call

Zoom Video Conference

Please ensure to submit via email any learning evaluation conducted and the last two (2) school reports to eduphase@gmail.com. Registration is completed once documents have been submitted and payment confirmation submitted.

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