All-Access Elite Application

All-Access Elite Application
Are you filling out this form for yourself or for someone else?
Name of person filling out the form

First NameLast Name
If you're a parent filling this out for your teen, please provide YOUR email address.
example@example.com
If you're a parent filling this out for your child, please answer the following questions from your child's perspective, using their information.

If you're a student filling out the form for yourself, answer the questions from your own perspective.
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
What grade level are you?
What type of school do you attend?

Other
What's the biggest academic challenge you're facing right now?
Have you worked with a coach or tutor before, and if so, what worked or didn't work?
What's driving you to seek this kind of support right now?
What would success look like for you by the end of this semester?
Coaching only works if there's follow-through between sessions. On a scale of one to ten, how would you rate your ability to complete small action steps each week, even when things get busy?

1

2

3

4

5

6

7

8

9

10

1 is Unable or unwilling, 10 is Able & willing
Do you have any diagnosed or suspected learning differences, such as ADHD or dyslexia, that would help me coach you more effectively? (Optional)
Is there anything else you’d like me to know about your goals, timing, or situation?
Coaching occurs based on an ET time zone. What time zone are you in?
We accept a limited number of All-Access Elite clients, so want to ensure a strong mutual fit. If offered a spot at the Elite level, are you prepared to enroll and secure your position with payment within 7 days?
After submitting your application, you will receive a response within 7 business days.

If you're application is accespted and you're invited to a discovery call (the next step to ensure compatiability), please ensure anyone involved in the enrollment decision is able to attend, so questions can be addressed together.
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