School/District Pre-Consultation Survey
Please take a moment to complete the pre-consultation form. It will help direct our consultation meeting by providing a glimpse of where you are and how to best assist you in reaching your goal. After you submit the form, you will receive an email to schedule your consultation meeting. We look forward to meeting with you.
Sign in to Google to save your progress. Learn more
Email *
Name *
Title/Position
Institution Name and Address *
Preference of communication *
If your preferred form of communication is the phone, please select preferred time frames.
What reading concern or goal would you like to address? check all that apply *
Required
What framework(s) would you like to refine and/or integrate into literacy instruction? *Check all that apply, but check N/A if your focus is Culture of Literacy *
Required
If applicable, what is your students' current level of proficiency, as it relates to this concern/goal? - independent reading levels, vocabulary acquisition and foundational skills, reading standards *
How have you addressed the concern or goal in the past? And with whom? What school/classroom resources are currently being used? ie- You may have conducted a book study around Guided reading - with teachers, lead teachers, coaches, APs, etc and/or purchased a guided reading library  *
What support service model would you like to receive? *
Required
When would you like to receive the services. Check all that apply *
Required
Approximately how many team members would receive support? Please include admin, teachers, teaching assistants and/or student teachers *
Schools: What resources have already been purchased? And/or have you allocated funds to purchase resources?
 
Districts: Do the participating schools have the resources needed to implement what they learn? And/or will they have them once our sessions begin?
Please share anything else regarding your school or district demographics that will help paint a clear picture on how to support you.
What is the tentative start date? *
MM
/
DD
/
YYYY
What is your projected budget for this partnership? * At minimum, please provide an estimate.  *
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms