Student Information Form for Academic Tutoring
After completing, we will email you with our individualized plan and next steps to schedule tutoring.
High School Graduation Year
So that we can get back to you
Parent Cell Phone Number
Which high school does he/she attend?
What is his/her approximate GPA? (Prefer unweighted)
3.8 - 4.0
3.5 - 3.79
3.3 - 3.49
3.0 - 3.29
2.8 - 2.99
2.5 - 2.79
For each content area, what type of rigor is being pursued in the junior and senior years? In what level of course work is the student enrolled?
What high school math course is the student taking this year?
Geometry (Math 2)
Algebra II (Math 3)
Academic Area(s) for which tutoring is requested
Please explain in detail the circumstances which created a tutoring need.
Does the student have any special needs, e.g. IEP, 504, ADHD, Disabilities? If so, please describe in detail so we can best serve the student.
Please list any medications your child takes for school and tutoring.
Is there any additional information which would be helpful to LEAP?
Does your student tend to run out of time on standardized tests?
Does your student have test anxiety?
IF yes, is your child medically treated for anxiety with medication or counseling?
Was your diagnostic/practice taken with LEAP.
Yes, with LEAP.
How did you hear about LEAP?
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