Application Instructions

Step 1: Complete and submit the online Program Application Form. If you require this form to be provided in an alternate format, or if you require assistance completing this form, please contact the LDANR office at info@LDANiagara.org or (905) 641-1021 and we will be happy to accommodate.

Step 2: Submit supporting documentation (proof of a diagnosed, identified or suspected learning disability). Supporting documentation may include:

Most recent report card OR progress report (*required, unless otherwise arranged with the Program Coordinator);
Individual Education Plan (*required, if applicable);
Assessments (if applicable);
Teacher Feedback Form (if possible – Click Here for the Teacher Feedback Form);
Any additional information that you feel may be useful in determining the applicant’s needs for the program.

Supporting documentation can be uploaded to the Program Application Form, or emailed to the appropriate Program Coordinator. Other forms of documentation may be accepted in lieu of a report card/progress report with prior approval from the Program Coordinator. For questions regarding acceptable documentation, please contact the LDANR office.

Once received, applications will be screened for eligibility. LDANR programs are designed for individuals with learning disabilities, not other exceptionalities. If unsure of eligibility, contact the LDANR office prior to completing the form. Following screening, applicants will be notified closer to the program start date regarding the status of their application. Following acceptance into the program, program payment will be required, if applicable. Subsidy and payment plans may be available.

Important Notes:

The application is NOT CONSIDERED COMPLETE until the applicant’s most recent report card/progress report has been received (unless other documentation is arranged with the Program Coordinator).
When completing the application form, it is suggested that you have a copy of the applicant’s report card handy.
Be sure to click ‘Submit’ when you have completed the Program Application Form.
You cannot save the Program Application Form.

"*" indicates required fields

Step 1 of 5

What are the applicant's personal strengths?*
i.e. kind, caring, friendly, funny
What are the applicant's academic strengths?*
i.e. addition/subtraction, organization, reading novels, art class
What are the applicant's special interests, abilities, hobbies, sports?*
i.e. baseball, swimming, art, video games
What does the applicant struggle with because of their learning disability, regardless of if they have an official diagnosis?*
i.e. adding two digit numbers, reading long words, focusing, math, social skills etc.
What embarrasses the applicant most?
i.e. difficulties in group setting, being singled out
Does the applicant tire quickly when completing academic tasks?*

Yes

No
How does the applicant function in a group setting?*
i.e. better one-to-one, is shy in a group etc.
What would you like the staff and volunteers working with the applicant to know about them?*

Does the applicant follow verbal directions well?*

Yes

No
Does the applicant follow written directions well?*

Yes

No
Please identify any behavioural issues the LDANR should be aware of:
Physical Aggression*
i.e. hitting/kicking/biting

Yes

No
Please provide further detail:
Verbal Aggression*
i.e. swearing/insulting others/disrespectful language

Yes

No
Please provide further detail:
Defiant Behaviours*
i.e. refusals to participate/transition

Yes

No
Please provide further detail:
Tendency to Flee*
i.e. run/escape when frustrated/upset

Yes

No
Please provide further detail:
Other than those behaviours listed above, if the applicant displays other forms of behaviour issues, please list them in the space provided:
**Refunds will NOT be provided if the applicant is removed from a program due to misconduct.

Please confirm that you would like the applicant to participate in this opportunity by carefully reading and agreeing to the statements of understanding below:
I acknowledge that this is an in-person program and will ensure that the child in my care has a reliable ride to and from program each day of the program.

Waivers and Conditions of Enrollment:

I hereby authorize the administration of any and all emergency medical attention that the applicant might require as a result of injury or sickness while attending LDANR programs.

I hereby agree to comply with the LDANR's policies on anti-discrimination, violence and harassment. This is with the understanding that non-compliance may result in my removal from LDANR programming, thereby requiring a designate to pick-up and drop-off the applicant.

I hereby release the LDANR, its directors, staff, agents and members from any loss, personal injury, accident, misfortune or damage to the applicant or their property, with the understanding that reasonable precautions shall be taken to ensure the health and safety of the applicant.

I understand that the information collected on this form will only be used to assess the applicant's eligibility for programming. This information will only be shared with LDANR staff and volunteers.

I understand that for the program to be effective, and out of respect for the program staff, volunteers and those who did not get a spot in the program, LDANR requests that clients commit to attending each session of the program. If attendance is irregular or too many sessions have been missed the participant will be asked to leave the program to open the spot up to another participant.

I understand that for the safety of the volunteer staff and other participants, LDANR has the right and responsibility to take actions such as phone calls home and possible dismissal from program if a participant exhibits continual inappropriate behaviour.

I understand that the LDANR charges a fee for some of our programs, which must be paid prior to the program start date. For more information on program fees, please visit the program-specific pages on the LDANR website. If clients require financial aid to access the program, clients may apply for subsidy by filling out a Program Subsidy Application Form.

I understand that for a program to run, enough eligible applicants must apply for the program. If there is low enrolment, the LDANR has the right to cancel any program at any time.

I understand that, if the LDANR must cancel a program date due to circumstances outside of their control (e.g., inclement weather), no refunds will be issued. The LDANR will make an effort to reschedule the cancelled session where possible, but there is no guarantee that a cancelled session will be made up.

I understand that data is collected from LDANR programs to be used when reporting to funders/sponsors. All information used for reporting purposes is kept confidential and only used by LDANR staff. Participant names are removed and participant data is kept anonymous. Possible data sources used for reporting purposes include test scores, pre and post tests, ages, type of LD diagnosis. If you do not wish for the applicant's assessment data to be used for research purposes, please make note in the comment section below, or contact the LDANR office.

Payment instructions:
Prior to making any payments, please wait to receive notice of the applicant's acceptance into the program you've applied for. Our preferred method of payment is PayPal.
Cancellation policy:
Full refunds will not be provided for any cancellation or withdrawal requested by a client from any LDANR program or service. Under extenuating circumstances, a partial refund may be issued, as determined on a case-by-case basis, and an administrative fee will apply. Clients who must withdraw from a program due to circumstances outside of their control may make a request for a refund to the Program Coordinator. Please note that membership payments cannot be refunded.
I have read and hereby accept the above waivers and conditions of enrolment and give the LDANR permission to share the applicant's information with the appropriate staff and program volunteers.*
I agree
Please type your name in the space below to confirm that you have read and agree to the waivers and conditions of enrolment:*

Supporting Documents
If you have the applicant's supporting documents on hand, you can upload them in the space below. If not, the documents can be emailed/scanned to the program coordinator after you have submitted the application.
Supporting documents include: Most recent report card or progress report, Teacher Feedback Form, Individual Education Plan (if applicable), Assessments (if applicable). Please note: Applications are not considered complete until the applicant's most recent report card or progress report has been received, unless alternate arrangements have been made with the Program Coordinator.

Drop files here or

Max. file size: 20 MB, Max. files: 4.

Teacher Feedback Form
Please have the applicant's teacher complete the Teacher Feedback Form below. This will help LDANR further determine your child's needs for the program.
Click Here for the Teacher Feedback Form

Questions or Comments
If you do not receive a confirmation/thank you message after submitting your application, please contact the office at info@LDANiagara.org to ensure we received it.
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