APPLICATION FORM EIL | PERA MAY WEBSTORE

Emotional Intelligence Lab Enrolment

Ages 5–8 | 9–12

This program supports children in building emotional literacy, resilience, and self-awareness through creative learning.

Please share a little about your child so I can ensure the right placement.

Due to limited availability, not all applications can be accepted immediately. Pera will personally review and be in touch within 1-3 working days as to whether she feels 1:1 sessions or joining group sessions will be the best place to start. To note 5 YRO in most cases are suggested to start with 1:1 before integrating into group sessions.

Thank you so much for taking the time and considering such a wonderful opportunity for your child's development!

First name

Last name

Phone

Child’s Name & Age

What has drawn you to this program for your child?

What would you love your child to gain from this experience?

Is your child currently experiencing any emotional, behavioural, sensory, or learning challenges I should be aware of?

Has your child previously worked with any therapist, support worker, or specialist?

Are you prepared to commit to the full term and support your child’s integration at home?

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