edit_document Admissions Process

Start Your Child's Journey With Us

Please complete this intake application to help us understand your child's unique needs. Our team will review your information securely and reach out to discuss the best path forward.

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Intake Application

All information is kept strictly confidential.

Student Information

First Name

Last Name

Date of Birth

Current School (if applicable)

Current Grade

Primary Diagnosis / Condition (if any)

Parent / Guardian Information

Full Name

Email Address

Phone Number

Services Requested

Primary Program Interest

Select the main service you are inquiring about today.

Accepts Insurance Individualized Plans

Tell Us About Your Child

What are your child's greatest strengths and interests?

What are the primary challenges they are currently facing?

What are your main goals for joining Kids Way Maker Academy?

By submitting this form, you agree to our privacy policy and consent to being contacted regarding your application.