Impact Academy: Tutoring Pre-Enrollment Survey
Please complete one survey per student and use or create and use a GMAIL ACCOUNT when completing this form. Thank you.
Do you have a family member or close family friend in the program? If yes please list the scholar or tutor's first name.
Current Academic Instruction Model
Full-Time Distance Learning
Full-Time In-Person Instruction
Hybrid Model: (combination of both in-person and distance learning)
Grades K-2: Reading & Writing
Grades 3-5: Reading & Writing
Grades 6-8: Reading & Writing
Grades K-2: Math
Grades 3-5: Math
Grades 6-8: Math
Grades 6-8: Science
A copy of your responses will be emailed to the address you provided.
Page 1 of 1
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service