The Hub -- Interest Form

Child's Name

First NameLast Name

Child's Birthdate

Date

Parent/Guardian Name

First NameLast Name

Parent/Guardian Email

example@example.com

Which cohort meeting time(s) would be of interest?

When would you prefer to start?

How would you describe your child's education for the past year (optional; can pick more than one):

What's the main benefit you'd want your child to experience if enrolling in The Hub's program?

Please provide a brief description of your child (e.g., talkative, shy, curious, creative, etc.). Also please list a few of their main interests, plus anything else we should know about them that could affect their experience in a group setting.

Do you have any questions for us that weren't answered on The Hub's website, or anything else to add? You can either list them here, or let us know if you'd prefer to schedule a meeting to go over your questions/comments interactively.

Where are you based? (optional)

How did you hear about The Hub? (optional; if Facebook, please specify which group)

Thank you for your interest! We will review your form and get back in touch in the next one or two business days.