Homeschool Consultation Form

Homeschool Consultation Form

by Sarah Gowayed Homeschool Consulting
Parent's Full Name
Parent's Phone Number
Parent's E-mail
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Student's Full Name
Age
Current Grade
Where is your child currently attending school? (i.e public, Islamic, secular private school, Christian private school)
Sex
Questions and Details:
What are your primary reasons for homeschooling:
What goals do you have for your child this upcoming school year?
What are your child's goals for her/himself?
Which subjects does your child enjoy the most?
Which subjects are your child's strengths?
Which subjects does your child find difficult/challenging?
Please ask your child what particular subjects/topics they would like to study this year. Write their answer below:
What extra curricular activities, sports or interests does your child have?
Is your child able to focus during online learning?

YesNoSometimes
Would you consider online classes:

Part-time (1-2 classes)Full-Time (All subjects)Not at all
Does your child have any diagnosed or suspected learning disability?
For high school students: Are you interested in taking dual credit classes?

YesNo
For high school students: Are you interested in internship or shadowing opportunities? If so, in which careers/industries?
What dates/times work best for you to meet for a consultation?
Are you interested in coaching or curriculum planning? For details and prices go to: https://www.sarahgowayed.com/pricing

CoachingCurriculum Planning
Please write a note below if there is anything else you'd like to mention (i.e. employment situation for both parents. Do both parents work? etc.)
Should be Empty: