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Assessment Service Form

Please fill in this form and complete all parts. Upon submission, you will be required to submit a non-refundable fee of $350 which is payable by cheque or electronically to

Claremont Educational Services, Inc.

Admissions, The Claremont School
C-1, 310 Danforth Avenue
Toronto, ON M4K 1N6

Student Information

Full Name
Please type your full name.
Year applying for
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Grade applying for
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Applying For
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Terms: Consultation fees are paid in advance, whereupon a meeting will be scheduled via phone or email. Assessment fees are paid 50% in advance and 50% on receipt of report.
Date of Birth (dd/mm/yyyy)
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Child lives with
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Home Address
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Diagnosis of dyslexia or learning disability by a doctor or psychologist
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Current School
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School Address
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Allergies
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Medication
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Parents' Information

Parent 1 name
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Occupation
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Home Address
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Postal Code
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Home Phone
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Cell Phone
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Work Phone
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Work Place
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Work Address
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E-mail
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Parent 2 name
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Occupation
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Home Address (if different)
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Postal Code
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Home Phone
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Cell Phone
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Work Phone
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Work Place
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Work Address
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E-mail
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Terms
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If available, please email or mail us the following:

  • 3 most recent report cards
  • Individual Education Plan (IEP)
  • IPRC Information

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Toronto Star Feature

Discovering Sanctuary for Unique Learners (first published in the Toronto Star, Feb 18, 2017).

Please Consider Donating

to The Claremont Dyslexia Foundation, a not-for-profit foundation providing bursaries and grants for students with dyslexia.

Call 416-778-6336 or email us for more information.

 

Dyslexia

Dyslexia Assessment, Testing and Consultation is available.  More information...

Important Dates

Oct
24

24/10/2017

Oct
27

27/10/2017

Oct
30

30/10/2017

Nov
7

07/11/2017

Nov
14

14/11/2017