P2E Summer Pilot Interest Form 2019
*2 months of online academic coaching around your child's strengths, interests and academic needs.
*June 3rd through August 2nd / 8 weeks x 30-minute sessions weekly
*Discounted rate associated with this pilot is $365.00. (Normal rate is $400.00 for 8 sessions)
We just ask for feedback along the way!
Thank you for your interest! -Passion2Educate Crew
Email address *
Your Name *
Child's Name *
How did you hear about this pilot? (name of person, etc.)
Best way to connect with you... *
Required
Phone number (we will only use if you specify phone or text as your form of communication)
What grade will your child be in for the 2019-2020 school year? *
What kind of support are you most interested in? *
Please indicate when your child might want to meet with their academic coach. (Check all options that might work for you.) *
Mon
Tu
Wed
Thu
Fri
Morning (between 8 and 10 am)
Mid-day (between 10 am and 1 pm)
Afternoon (between 1 and 5 pm)
Evening (between 6 and 8 pm)
Is there anything else we should know about working with your child?
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of Educators Cooperative. Report Abuse