Some of our classes are also offered online through Zoom! If your student is interested ONLY in virtual classes, please complete the application form below. After we have processed your submission, you will receive an email with an explanation of how to register for classes. Thank you!

Virtual Program Application

  • Name of the participant (child)
  • Name of Parent/Guardian
  • Parent or Guardian Phone
  • Please enter the PRIMARY email address
  • Gender of child (for grant reporting only)
  • MM slash DD slash YYYY
    Child’s birthdate
    You may select more than one.
  • Please describe your child’s other disabilities.
    Child’s ethnicity (this field is for Grant Reporting Only) You may select more than one.
  • Is your child Medicaid Eligible? (If you are on the wait list, please answer “yes”). This is for grant reporting purposes only.
  • Is the CHILD’S earned income above or below $12,490? This is for grant reporting purposes only.
  • Any other information which would be helpful to ensure participant’s enjoyment?
    Please check all IC programs your child might be interested in participating in.
    You must accept the IC Waiver to be considered for participation.
    You can view the IC Waiver in a new window.