Unless U Admission Interest Form
Below are a few details about Unless U:

Operating Information:
- Days: Tuesday - Friday (year round)
- Hours: 9:00AM-3:00PM (before and after school is available)
- Fees:
- Four days a week - $125 a week
- Three days a week - $100 a week
- Two days a week - $80 a week
(There is some Tuition assistance available)

*Unless U is an independent organization and does not accept the Medicaid Waiver*

- Current Location: Shades Mountain Baptist- 2017 Columbiana Road, Vestavia Hills, AL 35216
- Future Location (Beginning late Spring 2021): 737 Chestnut Street, Vestavia Hills, AL 35216

Unless U Virtual Services:
Due to COVID-19 we have had to expand our services and meet many of our students' needs virtually. As you know, we have a waiting list. The virtual classes are a way for your student to go ahead and enroll in Unless U while waiting for a spot to open up. We are also giving priority to students on the waiting list that join us virtually. This means you will jump up on the waiting list.

Our Unless U Virtual Package is $60 a week, and it includes:
- Academic classes from 9:00-11:30 Tuesday-Friday and an afternoon elective from 12:20-12:50
- We have packet pickup on Mondays at Unless U from 9:00 - 1:00, this packet contains all of the activities, worksheets, etc for the week that coincide with the Zoom lessons. We also have a couple bible study workbooks that we will use for the entire semester. The Packet Fee is $3.00 for each week.
- If you cannot pick up a packet, you can print the activities at home with a link that we will send you.
Email *
Your Name *
Phone Number *
Your Student's Name *
Your Student's diagnosis *
How did you hear about Unless U? *
How old is your student? *
Are you interested in virtual classes or in-person services? *
Does your student have independent self-care and self-help skills, (i.e., toileting, eating, etc) *
Is your student able to follow simple verbal instructions? *
Our classes age respectful but are broken down by academic ability level. Which class do you believe your student would fall in? *
Please describe your student's social and life skills. (Ex: appropriate conversation, social cues, problem solving, levels of independence, how they help around the home, etc) *
If Unless U was a good fit for your family, when would you like to enroll? *
Would your family need to apply for Tuition Assistance? *
If Unless U was a good fit for your family, what days of the week would you prefer to be enrolled? *
Required
The Board of Unless U has deemed it necessary for anyone involved in any in-person programming at Unless U to get the Covid-19 Vaccine as well as the Influenza vaccine as soon as it becomes available to you. Unless U has adopted this policy to safeguard the health and well-being of students, staff, volunteers, and their families. Has your student received the Covid-19 Vaccine or are you willing for your student to receive the vaccine? *
Have we already met for a student interview? If so, when was our interview? *
If you would like to schedule a student interview, what days of the week work best for you? *
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of Unless U. Report Abuse