JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
LINGUAPHILE SKILLS HUB INITIAL ADMISSIONS PROFORMA
Please fill up this initial proforma to the best of your knowledge and understanding for the child
* Required
Full Name of child
*
Your answer
Age of the child
*
Your answer
Full Name of Parent
*
Your answer
Address
*
Your answer
Phone number
*
Your answer
What type of Learning challenges does your child have?
*
Your answer
Has a Psyched assessment been completed?
*
Yes
No
Is your child attending school currently?
*
Yes
No
At what grade would you want to enrol your child?
*
Primary [upto Grade 5]
Middle School [Grade 6 - 8]
High School [Grade 9 - 12]
Are you exploring online home based or classroom learning solutions?
*
Online Home based
Classroom
Hybrid of Online and Classroom
Has any of the following been diagnosed for your child through a Psych-ed assessment (if completed)
*
Attention Deficit (Hyperactive) Disorder (ADHD)
Autism Spectrum Disorder (ASD)
Dyslexia (incl. Dyscalculia, Dyspraxia)
Cerebral Palsy (CP)
Asperger Syndrome
Other
Required
By filling up this questionnaire you agree to Linguaphile Skills Hub retaining the data provided and get in touch with you through the contact details.
*
Agreed by parent
Required
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. -
Terms of Service
-
Privacy Policy
Forms
