New Student Introduction Session
Complete this form to schedule your child's assessment and learning plan meeting, and to provide important information to personalize their summer experience.
Parent / Student Information
Parent/Guardian Name
*
First Name
Last Name
Parent Email
*
example@example.com
Parent Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Student Name
*
First Name
Last Name
What Grade Will Your Student Enter In The Fall?
*
Please Select
1
2
3
4
5
Student Gender
Female
Male
Will any siblings also be participating or potentially interested in Summer Learning Sessions?
Yes, i'm interested in sessions for another child
No, sessions are just for this child
Unsure
Second Student Information
Student Name
First Name
Last Name
What Grade Will Your Student Enter In The Fall?
Please Select
K
1
2
3
4
5
6
Student Gender
Female
Male
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Learning Snapshot
Has your child worked with a tutor before?
Yes
No
Not sure
Does your child currently receive any academic accommodations, learning support, or classroom services?(Examples: reading intervention, speech support, 504 plan, IEP, occupational therapy, etc.)
Yes
No
Are there any behavioral, sensory, focus, emotional, or learning considerations you’d like me to be aware of before our meeting?
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Scheduling
Book Your Introductory Session
*
Book Introductory Meeting
Should be Empty: