Parent/Guardian Info Sheet

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Child's Name

Please indicate if they prefer a certain nickname.

Parent/Guardian #1 Name and Phone Number(s)

Please indicate which number is preferred.

Parent/Guardian #1 Email address

This will be the main method of communication so please send updated information if your email changes.

Parent/Guardian #2 Name and Phone Number(s)

Please indicate which number is preferred.

Parent/Guardian #2 Email address

This will be the main method of communication so please send updated information if your email changes.

With whom does your child reside?

both parents

mom

dad

Other:

Clear selection

Do you have computer access at home?

yes

sometimes

Clear selection

Do you have internet access at home?

yes

sometimes

Clear selection

In your opinion, what are your child's strengths in math?

In your opinion, what are your child's biggest challenges with math?

Is there anything you feel I should know that will help me when working with your child?

Submit

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