Learning Interest Form
Thank you your interest in the Nontraditional World of Learning! Please fill out the form carefully and someone you email or call you directly. At DIJAH’s Diverse Training Services, we Develop It ( skills and communication) Just As it Happens!
Student Name
*
First Name
Middle Name
Last Name
Student Name
First Name
Middle Name
Last Name
Student Name
First Name
Middle Name
Last Name
Parent's Name
*
First Name
Middle Name
Last Name
Last Grades Your children Completed
Homeschool or Nontraditional Learner
*
Yes
No
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Number of Children in Your Home
Student E-mail
example@example.com
Parent E-mail
*
example@example.com
Cell or Home Number
*
Alternate Number
Tutoring Subjects
Please Select
ELA( English, Reading & Writing)
Math
GED Prep
Program Interests
*
Please Select
Hybrid k-12 Workshops
Reading Pods
The Biz Bag - Social Studies, Grammar , Writing , Financial Literacy, Business Planning
The Biz Bag Drop Ins -FREE Introduction
GED Prep
Coop -Worksheet Packets, Portfolio Prep, Parent Support, Help Grading
How to Start a Nontraditional Learning Business
Parent Support
Parent & Business Community (EmParentU)
Homeschool Curriculum Help
Homeschool Guidance & Direction
Other
Where did you learn about us
Please Select
Facebook
Instagram
LinkedIn
Website
Previous Customer
Referral
MD Dept of Education site
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