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Educational Therapy Center of Princeton: New Student Waitlist 2025

Thank you for your interest in our practice. We pride ourselves in providing personalized, one-on-one attention to each of our students; as such, we are currently at capacity. We are aware of the sense of urgency that many parents feel when looking for help for their child, so we appreciate your patience. 

When space becomes available, we will reach out in the order that inquiries are received. We appreciate your understanding and look forward to connecting with you as soon as possible!! 

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Your Name (Parent/Guardian) *
Your Email (Parent/Guardian) *
Your Phone Number (Parent/Guardian) *
Relationship to Child *
Student: Name *
Student: Current Age *
Student: Gender
Student: Current School
Student: Current Grade Level
Please summarize why you have chosen to seek educational therapy for your child at this time: *
How did you hear about our practice? *
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