KUBO STEM Program Application
Thank you for your interest in our STEM programs! Please fill out the application below and we will contact you soon regarding more information or to help finalize your registration to the program that fits your child's interests and needs best. 
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Email *
Parent's Name  *
Child's Name & Pronouns  *
Child's Age *
Is your child able to follow 1-step directions?  *
Can your child communicate vocally or with AAC device (ask for wants/needs, respond yes/no, short phrases)?  *
Is your child independent in a variety of self-help routines (e.g., toileting, dressing)?  *
Does your child engage in any high risk aggression/self-injurious behaviours or is a flight risk?  *
What are your child's interests? (E.g., interested in Minecraft, LEGO, etc.) *
What are their social goals? (E.g., initiating social connections, engaging in conversation/commenting w/ peers, finding other peers with similar interests to connect with, etc.) *
Is there any other information you would like to share regarding your child?  *
Which Group Session/Program are you interested in?  *
Which Day Group would you be interested in? *
If you are not available during our available time slots, which weekdays and times work best for you? (If we get enough interest, we might be able to open a group for that day & time!)
Would you like to register a sibling? (40% off monthly fees for non-autistic siblings) *
Do you have any other comments or questions for our team?  *
A copy of your responses will be emailed to the address you provided.
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