BASEC Pods - Request Form
Thank you for your interest in BASEC Pods! We have received an overwhelming response from our community regarding this option, and in order to begin matching our teachers to families, we request that you fill out the below information.

If we are able to offer a pod to you, we will be in touch with next steps after this form has been submitted.
Email *
Pod Organizer's Name (First, Last)
Pod Organizer's Phone Number
Pod Organizer's Address
Please list the address of the home where the pod will meet
Are you interested in the half or full day pod?
Please note that exact times will be modified depending on your pod's school day start and end times
Clear selection
How many students are in the confirmed pod?
*Please select "unsure" if pod is not yet confirmed
Clear selection
What are the grades of the students in the confirmed pod?
Choose all that apply. *Please select "unsure" if pod is not yet confirmed
Please describe the type of support your pod group is looking for
In order to best match you with a teacher, please give us as much detail about the type of support your group is looking for
Are there any additional details you would like to share, or questions you have about BASEC Pods?
A copy of your responses will be emailed to the address you provided.
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