Thrive Registration Form Please complete the following information: (Required fields noted with an “*”) Student's Name * First Name Last Name Parent / Gardian Name * Additional names can be added post-registration First Name Last Name Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Phone * (###) ### #### Email * Thrive Campus * Preferred Thrive Location Charlotte NC Rock Hill, SC Expected Start Date * January February March April May June July August September October November December Date of Birth * MM DD YYYY Student's Learning Level * Homeschool ID # Accomodations IEP 504 Plan Other Does student currently receive therapy services? * YES NO If "YES", which therapies? Check all that apply Applied Behavioral Analysis (ABA) Occupational Therapy (OT) Speech Therapy Physical Therapy Other If "Other", please provide details Additional Comments Please provide any additional information that would be helpful for student placement Thank you for registering with Thrive Day School. We will contact you within 2 business days.
