Returning Students

  • Submission of forms does not equate to acceptance in program.
  • The Conductive Learning Center will notify you as to acceptance into the program.
  • Please click here for a printable version of this form.

Applying for Session:

I (Sept.) II (Oct.) III (Nov.) IV (Dec.) V (Jan.) VI (Feb.)
VII (March) VIII (April) IX (May) Summer Camp

Last Session Attended in the Program:

I (Sept.) II (Oct.) III (Nov.) IV (Dec.) V (Jan.) VI (Feb.)
VII (March) VIII (April) IX (May) Summer Camp

Child's Personal Information

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Medical Updates

Present Condition

Please provide an update regarding current skills in:

General Questions




To provide opportunities for preschool and school age children with motor challenges to achieve optimal physical, cognitive and social independence through the application and promotion of conductive education principles.CLC is a 501(C)3 Organization