InfinityED New Student Intake Form
This form is used to collect basic interest and general information regarding service needs, education level, availability, etc. 
Email *
Learner's Name 
If you are the guardian there will be a separate section for your personal information.
 *
Learner's Phone Number 
If you are a guardian, you can provide your information in a below question.
What Grade/ School Level is the Learner in? *
Learner's Preferred Meeting Place? 
(Remote, at InfinityEd center, at home, hybrid)
 *
Required
Learner or Learner's Guardian? *
Required
Guardian/Parent/Other Inquirer Information
Guardian's Name
Guardian's Contact Information
Please provide your phone number and best email to reach you at, if not one used to complete this form.
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