Pure Heart Foundation: Center for Virtual Learning
Pure Heart Foundation is looking to provide assistance to families who have a scholar who is participating in virtual learning for the 2020-2021 school year. Please provide information regarding your scholar*

Each scholar will need a seperate form*
Scholar's Full Name [First/Last] *
Scholar's School *
Scholar's Grade Level *
At what capacity is your scholar participating in virtual learning *
Does your scholar have the technology and internet access to participate in virtual learning? *
As a response to COVID 19, If Pure Heart Foundation were to create a learning space at our current location during school hours, would you want your scholar participate? *
If the space were created, what days would the be the most helpful for a learning space at the Pure Heart Home? *
Required
If the space were created, how often would your scholar use the learning space? *
If the space was created, would your scholar have reliable transportation to and from the Pure Heart home?
Clear selection
Are you experiencing any childcare barriers because of COVID-19, including daycare, after-school programing, etc.
Clear selection
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