NDA "Learn with Us!" Request Form
Thank you for your interest in our "Learn with Us!" program! Neurodiversity Ambassadors is a volunteer-based organization. Our tutors are talented, diverse students from around the world. Please fill out this questionnaire as accurately as possible so we can match you with the best tutor!
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Last name of student: *
First name of student: *
Town, State, Country (ex. Bridgewater, NJ, USA; 서울시 강남구 대한민국)
Student's grade (if applicable):
Age *
Name of parent/guardian: *
Parent/guardian email: *
Parent/guardian phone number:
Which instrument(s) would your student like to learn? (Since we can't list every instrument, let us know about any other musical interests using the "other" option!)
Which subject(s) would your student like to be tutored in?
Would you prefer online or in-person tutoring? *
Do you have a location preference? 
Are there any qualities you would like your tutor to have? (ex. can communicate in Korean, etc.)
In order to make the best possible match, please tell us about your student's hobbies/interests/etc:
What are things that may upset your child?
Questions/Comments?
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