Free Game Academy Program Application

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I Am Applying For....Select an option to complete registration.
Me Someone Else
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Program Selection Which Program Fits Your Learning Needs Best?
Please Select
Please Select
Virtual Tutoring
Exam Prep
Homeschool Heroes (Membership Required)
Financial Literacy (Membership Required)
The Pit Stop Program 2024 (CC24 Award)
GED Program (Membership Required)
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Parent/Guardian Name
First Name
Last Name
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Relationship To Applicant
Please Select
Please Select
Mom
Dad
Grandma
Grandmother
Grandfather
Aunt
Uncle
Stepmom
Stepdad
Guardian
Teacher
School Counselor
Principal
School District
Translator
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Parent's Phone Number
Please enter a valid phone number.
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Parent's Email
example@example.com
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Preferred Communication Style How do you prefer to communicate (email, video calls, instant messaging)? Please select two or more.
Email
Text Messages
Phone Calls
Surveys and Feedback
Social Media
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Would You Like To Add An Additional Parent's Contact Information
YESNO
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Relationship To Applicant
Please Select
Please Select
Mom
Dad
Grandma
Grandmother
Grandfather
Aunt
Uncle
Stepmom
Stepdad
Guardian
Teacher
School Counselor
Principal
School District
Translator
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Parent/Guardian Name
First Name
Last Name
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Parent's Phone Number
Please enter a valid phone number.
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Parent's Email
example@example.com
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Student's Name* This field is required.What is your full legal name?
First Name
Last Name
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Student's Age
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Student Birthday When is your birthday? (e.g., MM/DD/YYYY)
Date
Year
Month
Day
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Gender* This field is required.Please select your gender or choose 'Prefer Not to Say.'
Please Select
Please Select
Male
Female
Non-Binary
Prefer Not to Say
Other (Specify: ____________)
Decline to Answer
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Race/Ethnicity Please select your race/ethnicity from the options below (select all that apply)
Please Select
Please Select
Asian
Black or African American
Hispanic or Latino
Native American or Alaska Native
Native Hawaiian or Other Pacific Islander
White
Two or More Races
Prefer Not to Answer
Other (Please specify): _______________
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Preferred Pronouns What pronouns do you use? e.g., He/Him, She/Her, They/Them)
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Student's E-mail* This field is required.What is your primary email address?
example@example.com
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Preferred Communication Style How do you prefer to communicate (email, video calls, instant messaging)? Please select two or more.
Email
Text Messages
Phone Calls
Surveys and Feedback
Social Media
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Student's Grade
Please Select
Please Select
K
1ST
2ND
3RD
4TH
5TH
6TH
7TH
8TH
9TH
10TH
11TH
12TH
FRESHMEN COLLEGE
SOPHOMORE COLLEGE
JUNIOR COLLEGE
SENIOR COLLEGE
GRADUATE
GRADUATE STUDENT
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Phone* This field is required.What is your preferred phone number for communication?
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Address* This field is required.What is your current mailing address?
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
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Educational Background* This field is required.What is the highest level of education completed?
Please Select
Please Select
Currently Enrolled
High School Diploma
Trade School
Associates Degree
Bachelor's Degree (Undergraduate)
Master's Degree (Graduate)
Doctoral Degree (Ph.D., Ed.D., etc.)
Professional Degrees (e.g., J.D., M.D., D.D.S.)
Other Postgraduate Studies or Certifications
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Student's School
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School AddressStreet, City, State, Zip Code
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Preferred Days for Sessions
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
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Preferred Study Schedule What is the best time of day for us to meet? We do our best to accommodate schedules based on educators availability.
Weekday Morning (9AM-12PM)
Weekday Afternoon (12PM-4PM)
Weekday Evening (4PM-9PM)
Weekend Morning (10AM-12PM)
Weekend Afternoon (12PM-4PM)
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Select Subject Which subjects do you need the most assistance with?
Math
English/Writing
Science
History
Other
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Choose the statement that aligns best with your preferred learning style* This field is required.Select All That Apply: I learn best when,....
Seeing and observing information through visual aids.
Hearing and listening to explanations, discussions, or lectures.
Engaging in hands-on activities and practical experiences.
Reading and reviewing written materials at my own pace.
Discussing and interacting with others in a group setting.
Utilizing technology, such as online resources or interactive tools.
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Describe a past learning experience that you found particularly effective.
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What is your favorite subject in school?
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What is your least favorite subject in school?
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Do you prefer working alone or in groups?
1 on 1 Team Player
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What is your favorite color?
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What is your favorite snack?
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What is your favorite movie?
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What activities, game, and hobbies make you happiest? (e.g., reading, playing sports, drawing)
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When faced with a problem, do you like to solve it quickly or think about it for a while?
Solve It Strategize It
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Do you enjoy talking with others or do you prefer listening?
I Love To ShareI Love To Listen
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Describe yourself in three words (e.g., creative, logical, friendly).
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How do you feel when you have to speak in front of the class? (Comfortable, Nervous, Excited)
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What do you do when you’re feeling stressed? (e.g., talk to someone, take a break, work harder)
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When you’re doing something hard, do you like to keep trying, or do you ask for help right away?
Ask For Help Practice Makes Perfect!
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Are you interested in our membership packages?Ready to Join the Winning Team?
YESNO
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What are your primary academic goals or areas you wish to improve?
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What motivates you to achieve these goals?
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Previous Virtual Learning Support:* This field is required.Have you utilized virtual learning support before? If yes, please share your experience with previous academic support services.
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How do you prefer to receive support and feedback?
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What qualities do you value in an educator?How can we support you in reaching your goals?
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What specific academic support or character traits would you like your child to develop through this program?* This field is required.
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Does your child require any special accommodations or have any specific learning needs?* This field is required.
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Has your child previously received any academic or behavioral support? If so, please describe.* This field is required.
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Is there anything else we should know to help us support your child effectively?* This field is required.
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What aspects of the Pit Stop Program are most important to you, and how can we best support your child’s needs?* This field is required.
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Sign Here * This field is required.By submitting this application, you agree to the following commitments: Your child will attend the Pit Stop Program sessions as scheduled. You will keep the program informed of any changes or updates regarding your child's participation. Additionally, you will provide any necessary support to ensure that your child is prepared for each session.
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Have you attended any financial literacy classes before?* This field is required.
YESNO
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Financial Literacy Classes * This field is required.Please select the session/sessions you are mostly interested in learning more about?
How To Play Personal Finance
How To Play The Stock Market
How To Play Real Estate Investing
How To Start A Business (LLC)
How To Maintain Healthy Credit
Other
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Preferred Learning Materials:* This field is required.Select All That Apply
Online Resources
Printed Materials
Interactive Tools
Other (Please Specify)
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What money-related topics do you want to learn more about? (e.g., saving, budgeting, investing, smart shopping)* This field is required.
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Do you have something special you’re saving up for? Let us know what it is! (e.g., a new game, bike, or trip)* This field is required.
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Spending Behavior * This field is required.How do you usually spend your money? (e.g., saving most of it, spending on treats, donating to causes you care about)
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Have you had any experience managing money before? (e.g., an allowance, a savings account, helping with family shopping)* This field is required.
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Are there any financial skills you’d like to get better at? (e.g., sticking to a budget, understanding interest, making a savings plan)
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What are your main goals for preparing for the GED? (e.g., career advancement, higher education)
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Do you have any specific areas you need help with? (e.g., math, reading, writing)
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Do you require any special accommodations or support during the GED prep classes? (e.g., extra time, tutoring support)
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Please provide details of any previous GED preparation you have completed.Include the name of the program, dates of attendance, and any relevant outcomes or achievements.
69
Are you currently homeschooling your child?
YESNO
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What are your academic goals for the upcoming term or year?* This field is required.What are your academic goals for the upcoming term or year? Are there specific subjects or topics you would like assistance with?
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Does your child require any special accommodations or have any specific learning needs?* This field is required.What are your academic goals for the upcoming term or year? Are there specific subjects or topics you would like assistance with?
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Current School/Program:
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Choose Your Preferred Curriculum
Please Select
Please Select
All-in-One Curriculum (PreK-12)
Homeschool with IXL
American School (Grades 6-9)
The Critical Thinking Company (PreK-12)
The American Heritage Education Foundation (K-12)
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What excites you most about joining Homeschool Heroes?
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Do you have a quiet and organized area where you can focus during your sessions?* This field is required.Do you have a device for virtual learning, and can you reliably connect to the internet?
YESNO
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Google/Gmail Account Requirement* This field is required.Do you presently possess or are you open to acquiring a Google/Gmail account?
YESNO
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Do you have a reliable device (laptop, tablet, etc.) with a camera and microphone to connect to your sessions?* This field is required.
YESNO
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Is your internet connection strong and reliable enough for uninterrupted online learning?* This field is required.
YESNO
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I agree to bring a healthy snack, water bottle, notebook and pen/pencil, and any required textbooks or materials to each session.* This field is required.
I Agree Decline
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Exam PreparationWhich exam(s) are you preparing for?
SAT
Graduation/Exit Exam
ACT
Entrance/ISEE Exam
Other (Please Specify)
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Additional Information* This field is required.If you selected 'Other' or were referred by a member, please provide the full name and zipcode of the referrer.
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Does your child require any special accommodations or have any specific learning needs?* This field is required.
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Consent and AgreementBy signing below, I acknowledge that I have read, understand, and agree to the program’s terms and conditions, including the waiver of any claims or legal action against Free Game Academy, its employees, and affiliates. I commit to maintaining active participation, understanding that failure to do so may result in removal from the program without a refund for absenteeism. I also accept responsibility for staying informed of any updates to the program’s terms, policies, and conditions, which may be amended without notice
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How did you hear about us?* This field is required.
Word of Mouth
Social Media (Specify Platform: Facebook, Instagram, Twitter, etc.)
Online Search (Google, Bing, Yahoo, etc.)
Referral (Specify Source: Friend, Family, Colleague)
Advertisement (Specify Medium: TV, Radio, Print, Online)
Event or Sponsorship
Email Marketing
Website/Blog
Community Outreach
Current Student/Coach/Staff
Online Reviews (Specify Platform: Yelp, Google Reviews, etc.)
Other
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Rate Your Experience
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