Please complete the form below to arrange for an interview with the GEP staff. Once an applicant is pre-certified by the staff, participants will be notified and parents will be asked to complete the official confidential form via PSAS (Private School Aid Service). Applicants are required to disclose financial information to meet certain levels if eligibility. (*required field)

Name of applicant*:

Address:

City:

State:

Zip:

Phone*:

Email*:

Grade:

Age:

Parent/guardian name:

Address if different:

Why does this applicant have a need to participate in the GEP program?

Describe any prior horse experience that applicant has.

Does the applicant participate in any extracurricular activities that may impede participation in the GEP.

Does the applicant have a classified learning disability? Would the family be willing to share the IEP (Individual Education Plan)? Note: applicant does not need to be classified to participate in program