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Program Registration Form 2026-2027

Sessions effective August 1, 2026 - June 30, 2027
Please complete our registration form below. We will then contact you by email to book a call to provide more information about our programs, gather more details, and answer any questions.

For program descriptions please go to our website at reframeeducation.ca
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Email *
Learner Information
Please indicate if you are a new or returning client *
First and Last Name of Learner *
Preferred Pronouns of Learner *
Email of Learner (if applicable) 
Phone number of Learner (if applicable)
Select Level of Learner *
Name of Current School
Describe Learner Strengths *
Describe Learner Areas of Difficulty *
Does Learner have a Psych-Ed assessment report?  *
Diagnoses (suspected or identified)  *
Parent/Guardian Information 
First and Last Name of Parent or Guardian
Email of Parent or Guardian
Phone number of Parent or Guardian
Program and Scheduling Information
Select Session Type *
Required
Session Format *
Required
Preferred Days
* Please note: We do our best to accommodate your preferred days, and sessions are subject to practitioner availability. 
 *
Required
Preferred Start Times  *
Required
Please let us know how you heard about us? *
Required
Will you be using ASD funding from the Provincial Government? If yes, please ensure you have added Reframe Education as a service provider on the AF Portal *
Will you be receiving funding from a Third party? If yes, please ensure you have made arrangements with the 3rd party and provide the name of the institution  *
Additional Information or Questions
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