Application

Application Form

508 Brock Street South, Whitby, ON L1N 4K7

905-666-3960 | victoria@ama4kids.com

Children's Application
Program of Interest Age Range:

Child Information

Home Address:

Additional Information:

Are there any health considerations that would prohibit full participation in school activities?
Are you aware of any special needs/learning differences that would require special programming for your child?
Is your child vocal?
What language(s) are spoken at home?
Child Lives With: