Essentials of Effective Study
Application
Parent/Guardian Information
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
-
Area Code
Phone Number
Email
example@example.com
Student Information
Name
First Name
Last Name
Mobile Number
-
Area Code
Phone Number
Date of Birth
-
Month
-
Day
Year
Date
Grade
GPA
Name of School
School District:
My Student needs help with: (please check yes or no)
1: Discovering Learning Styles and Preferences
Yes
No
2: Creating a Powerful Mindset
Yes
No
3. Using Time Effectively
Yes
No
4: Creating and Achieving Goals
Yes
No
5: Processing Information into Your Memory
Yes
No
6: Rehearsing and Retrieving Information from Memory
Yes
No
7: Preparing for Upcoming Tests
Yes
No
8: Selecting a Reading System
Yes
No
9: Strengthening Reading and Notetaking Skills
Yes
No
10: Analyzing and Organizing Chapter Content
Yes
No
11:Strengthening Listening and Lecture Notetaking Skills
Yes
No
12: Using Technology
Yes
No
Parent/Guardian Name & Signature
*
Date
-
Month
-
Day
Year
Date
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Submit
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