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Student Tutoring Intake Form
Please provide information about your child's academic strengths, goals, concerns, and preferred learning approaches to help us tailor our tutoring services.
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Email
*
Your email
Student name
*
Your answer
Parent name
*
Your answer
School Name
*
Your answer
Grade
*
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
What are your child's strongest academic areas?
*
Your answer
What are your main tutoring goals or concerns?
*
Your answer
Which areas are difficult?
*
Reading
Spelling
Math
Word problems
Organization
Attention
Homework
Other
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What approaches have helped your child learn?
*
Examples
Visuals
Listening
Hands-on
Repetition
Discussion
Quiet practice
Not sure
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Send me a copy of my responses.
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