SCHOLAR'S EDGE TEST PREP
New Student Intake Form
Please complete this form so we can match your student to the right program and instructor.
STUDENT INFORMATION
First Name
*
First Name
Last Name
Last Name
*
First Name
Last Name
School
School District
Current Grade
*
7th
8th
9th
10th
11th
12th
PARENT / GUARDIAN INFORMATION
Parent/Guardian Name
*
Relationship to Student
Email Address
*
example@example.com
Phone Number
*
Format: (000) 000-0000.
Second Parent/Guardian Name
Second Parent Email or Phone
PROGRAM INTEREST
Which programs are you interested in?
*
SAT Prep
ACT Prep
PSAT Prep
STAAR Prep
TSI Prep
College Application Coaching
Preferred Format
Target Test Date (if known)
ACADEMIC BACKGROUND
ACADEMIC BACKGROUND
Rows
Most Recent SAT Score
Most Recent ACT Score
Most Recent PSAT Score
Target Score (if known)
1
Which subject area is most challenging for your student?
Math
Reading
Writing / English
About equal
ADDITIONAL INFORMATION
Has your student worked with a tutor or test prep service before?
Back
Next
No, this is our first time
Yes, with a private tutor
Yes, with a test prep company
Yes, through their school
How did you learn about Scholar's Edge?*
Friend or family referral
NCL (National Charity League)
YMSL (Young Men's Service League)
School counselor
Facebook
Instagram
Google search
Nextdoor
Other
If Other, please describe:
Anything else we should know about your student? Learning differences, scheduling constraints, specific goals, previous test history, etc.
Scholar's Edge Test Prep admin@scholarsedge.co (682) 235-9465 scholarsedge.co * Required field
Preview PDF
Submit
Should be Empty: