NeuroQuest Teen Hub Interest Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Thank you for your interest in NeuroQuest's Teen Hub! Please fill out the interest form and we'll be in touch with more information about this program for the 2025/2026 school year!

Parent/Guardian First Name *

Parent/Guardian Last Name *

Email *

Phone number *

What age range is your child? (if more than one child, please fill out a separate interest form for each child) *

What is your plan for schooling for 2025/2026 *

Homeschool with a charter

Homeschool PSA or Unschooling

Co-Op or Micoschool

Private School

Traditional Public School

Other:

What kind of services or classes are you most interested in for your child? (check all that apply) *

Teen Hub, Mondays and/or Wednesdays (ages 13-18)

Enrichment Classes, Tuesdays and/or Thursdays (ages 4-14)

Learning Quest, Mondays and/or Wednesdays (ages 7-18)

Academic Tutoring (ages 5-18)

Required

What days work best for your teen to attend a program? (check all that apply) *

Mondays

Tuesdays

Wednesdays

Thursdays

Required

What is your teen interested in learning about or doing in the hub? (check all that apply) *

STEM (including coding, robotics, game development, gaming, 3D Design & Print, etc.)

Strategy games/board games/cards/puzzles

Arts - music, painting, ceramics, crafting, digital design, fashion, etc.

Building/constructing/deconstructing

Theatre and/or Music (singing, playing an instrument, performing, etc.)

Public Speaking/Debate

Other:

Required

Is your child capable of attending classes and programs indepedently or will they have an aide/parent with them? *

Yes, my child can attend independently.

No, my child will have an aide or parent/guardian attending with them.

Other:

On a scale of 1-5, how do you feel about your child participating in and learning through esports/gameschooling? *

Not supportive/anti-screens

Very supportive/open to learning

Anything in particular you want to share about your child or what you're looking for? *

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of NeuroQuest.

Does this form look suspicious? Report

Forms