New Student Application

Application Information

Submission of forms does not equate to acceptance in program.

Following receipt of this application, our Program Director, Andrea Swiger, will reach out and go through your application with you to determine if your child is a potential good candidate for conductive education. If he or she is, an assessment appointment will be scheduled. A non-refundable assessment fee of $100 is due at the time of assessment. If you will not be able to travel to Grand Rapids, you will be asked to submit a Video Assessment. Guidelines for video assessment can be found here.

The Conductive Learning Center will notify you as to acceptance into the program.

Please click here for a printable version of this form.

New Student Application

Step 1 of 4

  • Child's Personal Information

  • MM slash DD slash YYYY
  • Please include names, ages and genders
  • Parent / Guardian Information

Our Mission

To provide opportunities for individuals with motor challenges to achieve optimal physical, cognitive, and social independence through the application and promotion of conductive education principles.