School Information
Health/Medical Information
Other Important Information About the Participant
Document Upload (All Applications)
Document Upload (For Applications to Educational/Therapeutic Programs Only)
Parent/Guardian 1
I hereby make an application for the participant to attend an Ivymount Outreach Program. I have filled out all of the information to the best of my knowledge. I acknowledge that submission of this application does not guarantee acceptance into an Ivymount Outreach Program.
Parent/Guardian 2
Please note that applications for educational/therapeutic programs require a $50 non-refundable processing fee.
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