Online Application

Apply to Exceptional Learners (EXL)

Complete the form below to begin your application. Fields marked with * are required.

Fill out online

Prefer paper? Print a blank copy, fill it in by hand, and bring it to the school office.

Student Information

First name *

Last name *

Date of birth *

Gender *

Nationality *

Languages spoken at home

Home address *

Curriculum *

Grade applying for *

Entry year *

Family

Child lives with *

Father

Not applicable

Full name

Profession

Workplace

Work phone

Cell phone

Home address

Mother

Not applicable

Full name

Profession

Workplace

Work phone

Cell phone

Home address

Primary contact for admissions

Email *

Phone *

Previous School History

Previous school name

School address

Last grade completed

Years attended

Reason for leaving

0/500

Health Form

Family doctor

Doctor's phone

Blood type

Immunizations up to date? *

Recent vision test? *

Allergies (food, environmental, medication)

0/500

Current medications

0/500

Chronic or significant medical conditions

0/500

Emergency contact

Full name *

Relationship *

Phone *

Address

Learning Support

Has the student been diagnosed with a learning disability? *

Does the student receive therapy or specialist support? *

Acknowledgments

Please read each statement, check the box to approve, and enter your initials on the right.

I certify that the information provided is accurate to the best of my knowledge, and I authorize EXL to contact the student's previous school and healthcare providers as needed.

Initials *

I understand and agree that once my child is registered at EXL, I am committed to paying the totality of the tuition and fees for that school year, regardless of withdrawal, absence, or dismissal.

Initials *

I acknowledge that the school reserves the right not to accept students whose family accounts carry past-due balances from prior school years.

Initials *

Signature

By signing below, the parent or legal guardian confirms that all information in this application is true and complete, and accepts the acknowledgments above.

Parent / guardian full name *

Relationship to student *

Date *

Signature *