Student Name:

Birthdate:

Learning Struggles:

Your student needs to be able to independently use the restroom to attend The Clowvazar Academy.

Program:

Session:

Behaviour History:

Current School:

Grade Level (K-12):

Guardian Full Name:

Email Address:

Alternative E-Mail:

Phone Number(s)

Availability:  Please explain what days you are most likely to be available for interviews. Interviews are never scheduled before 3:00PM . If you do not live in San Antonio, please let us know when you will be in town.

Application Fee: There is a $30 application fee that needs to be paid before you can schedule an interview. Reschedules are $15.00 / re-schedule. We will send you a link to pay this fee.