Intake form

Name *

Email address *

What grade is your child currently in?

What type of learning support are you interested in?

Please select at least one option.

Individual Tutoring

Group Tutoring

Digital Learning

In-Person Learning

Subject-Specific Assistance

Study Skills Development

Please specify the subjects your child needs help with.

Please select at least one option.

Mathematics

Science

Language Arts

Social Studies

Foreign Language

Art

Music

Physical Education

What are your preferred learning methods?

Please select at least one option.

Visual Learning

Auditory Learning

Kinesthetic Learning

Reading/Writing Learning

What is your preferred mode of communication?

What are your goals for your child's learning support?

Additional questions or comments

Please confirm that you are not a robot.

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