Request for Information about Capstone Summer Program
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Thanks for your interest in our Capstone Summer Program for children with behavioral and self-regulation difficulties.
Please enter the information indicated below so we can reply to your request. This information is never shared with others outside of Kurtz Psychology.

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First Name:
Last Name:
Home Phone:
Email Address:

How old will the child that you are concerned about be on July 1, 2020? (This program is designed for children 4-6 years old, entering Pre-K, Kg or 1st grade in the fall of 2020.)
4 years old
5 years old
6 years old
7 years old or older but you want us to still consider them
  • Comment:

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What grade is this child entering in the fall of 2020?
1st grade
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Please tell us how you prefer to receive more information about the Capstone program. You may check more than one option.
Please contact me to set up a free, no obligation phone call.
Please email me more detailed information.
Is there anything else you would like us to know about your situation before we speak with you?

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