FULL-TIME ACADEMIC SUPPORT - School Year Registration Form

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Email *

Student's Name *

First and last name

Date of Birth: *

YYYY

Current Grade: *

School name: *

Allergies: *

If you have any relevant documents such as psychological evaluations, IEPs, or 504 Plans, please send to tequoya@learninglabfl.com and/or aly@learninglabfl.com
*

I will send additional documents.

I do not have any additional documents to send.

Other:

Required

Do you plan to request reimbursement from Step Up for Students (Unique Abilities or New World) for Learning Lab services? *

If yes, please enter your Step Up ID Number (STEP ID) to help streamline invoicing for reimbursement:

Please review the Learning Lab Calendar before answering.

Will your child be absent for any dates not reflected on the Learning Lab calendar due to private school breaks, religious observances, or other known conflicts?

(If yes, list the dates below. If not, type “None.”)

Absences shared during registration may be considered for planning or tuition adjustments. Absences shared after registration will be subject to our cancellation policy for credit or makeup eligibility.

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