Enrollment Form
Please complete and submit the following form. Once Little Reading Coach receives it, we will send you an email to schedule a time for a Zoom chat session. If you have any questions, please send an email to littlereadingcoach@gmail.com.
Email address *
Parent/Guardian Name *
Student's Name *
Student's Grade *
Student's Address *
Cell Phone Number *
Does the student have an IEP or 504? *
What services are you interested in? *
Required
When are you looking to start? *
MM
/
DD
/
YYYY
How often would sessions take place?
Clear selection
How did you hear about Little Reading Coach? *
Where does the student go to school? *
Has the student been tutored before? *
What are you hoping Little Reading Coach can do for the student? *
A copy of your responses will be emailed to the address you provided.
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