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DLC Enrollment Request Form

Thank you for your interest in our school, Differentiated Learning Center! Please fill out the form below to request to join our waitlist. Please be aware that enrollment with Step Up is required for tuition assistance. We also offer ABA therapy through Licini Inc. We accept most insurances, but at this time we DO NOT ACCEPT MEDICAID. A member of our team will reach out to you with any additional information or questions.

Let's start with your personal details

*We do NOT take Medicaid*

Do you have any questions for us, and is there anything you'd like us to know?

How did you hear about us?

We will reach out to you as soon as possible, Thank you for your application!