top of page

Learning To Thrive

A.I.M. - Conquer The Canyon 2022

Student Enrollment Survey

Thank you for your interest In Raise The Roof For Autism's Life Learning Adventure Program.

Below is our initial Student Assessment Survey. For the current 2023 and 2024 programs beginning March of 2023. Acceptance is on a space-available basis for qualified applicants. Space is available  Applications are accepted and processed in the order they are received. 


This survey is designed to provide our Development Team with the information they require to assess our program's suitability for each student. Student eligibility and acceptance in the program are determined solely by our Development Team and the Director.


Active communication between our team, the student, and the parent during enrollment is important. We aim to match students and their parents to the best learning experience during our 10-week journey together. A key is to enroll students, and parents/caregivers whom we believe are committed to the time and effort it takes to complete the program. Each enrollment application is handled individually, and our team members will, of course, be with you every step of the way.

Here is what you can expect by completing this survey.

  • You'll receive a confirmation email that we received your submission.

  • In 1 or 2 business days, a member Development Team will review your application and make arrangements to connect with you using your preferred method. 

  • Once a final determination has been made, our team will assist you with completing our formal enrollment application and privacy and release forms and arrange for payment. 

  • Students and Parents are then connected with their educational professionals, who will provide complete information about the journey all of you will take together. 

This form and your privacy. The personal information you provide here is private and only shared with the team managers who directly advise and communicate with our student and parent clients. When accepted the personal information becomes a part of the student profile. If the student is not accepted in the program, the personal information is permanently deleted from our database. No one will contact you.

Communication Preference
Choose a time

Behavioral/Social Competence

How well does your child get along with others?

Achievements/Task Performance

School, Home, Other; How well does your child complete tasks/play?

Self Relations

Self esteem – mental and physical abilities, appearance, and self-worth; Self-care vs neglect; Self-regulation.

Self-Assurance and management – How does your child feel about and manage self?

Internal Status

General Contentment vs disturbance in thinking or feeling – How does your child feel and think?

Coping/Problem Solving

How well does your child identify and solve problems?
Does your child have a current IEP and transition plan?
Does your child participate in any extra-curricular activities?
Can both child and parent commit to participate in weekly virtual classroom sessions?

Thank You For Submitting Our Student Assessment Survey.

Our Team Will Respond Shortly.

bottom of page