New Student Application

Application Information

Submission of forms does not equate to acceptance in program.

A processing fee of $25 (which still must be sent by postal service, Fed Ex, etc.) must be received before your application will be considered.

If you are also submitting a video for assessment, your application will not be considered complete until the $100 video assessment fee (which still must be sent by postal service, Fed Ex, etc.) is received.

The Conductive Learning Center of North America will notify you regarding 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

  • Date Format: 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.