Thrive Application

Applicant Contact Information

First Name

Preferred Name

Last Name

Birthdate

Email Address

Mailing Address

Country

Street

City

Region

Postal Code

Thrive Specific Questions

Have you been diagnosed with a Learning Disability in any of the following areas?

Attentive Deficit
Please provide detail:

Math
Please provide detail:

Reading
Please provide detail:

Written Expression
Please provide detail:

Have you received any Accommodations and/or Special Services in the past three years?

Yes

Please list the Accommodations and/or Special Services received in the past three years.

Have you had an Individualized Education Plan or 504 Service Plan written in the last 12 months?

Yes

Have you had a multi-factored evaluation or psychological evaluation completed in the last three years?

Yes

Is there any other information that would be helpful in determining placement in the Notre Dame College Thrive Learning Center and the type of services that would be required?

Material Upload

Please upload any relevant material to your application.
Material not uploaded here will need to be sent to Director Denise Brown-Triolo, Ph.D. at dbrowntriolo@ndc.edu

Most recent Multi-factored Evaluation (MFE) / Evaluation Team Report (ETR) or psycho-educational assessment report

Most recent 504 Plan, Learning Plan or Accommodation Plan

Most recent Individualized Education Plan (IEP)

Most recent accommodations provided by another college/university

STATEMENT OF FULL DISCLOSURE AND SIGNATURE OF APPLICANT

By completing this application, I am applying for admission to the Thrive Learning Center of Notre Dame College, and I am aware that participation in the center will carry an additional fee of $2,800.00 per semester of use, payable to Notre Dame College.

Furthermore, I certify that the information I have provided is complete and accurate to the best of my knowledge. I understand that falsification or misrepresentation of any information may result in denial of admission or dismissal from Notre Dame College. If I am accepted by Notre Dame College and choose to enroll, I understand and agree that I will be expected to abide by all of the College's rules and regulations.

Electronic Signature
(Please check "Yes" to confirm this application)

Yes

Date

Admissions standards and policies are free of discrimination on grounds of race, creed, color, natural origin, age, sex, or handicap as defined by the law.