Email address *
Parent / Guardian Name(s) *
Your answer
Telephone #
Your answer
Child's Name *
Your answer
Child's Age *
Child's Gender Identity *
Which Class *
Are there any details about your child's learning preferences that you can share with us?
Your answer
Do you have a laptop that your child can use? *
Do you have a mouse that your child can use? *
Are you able to commit to providing snacks for 1 to 2 classes for the group? *
Tuition *
Final questions / comments?
Your answer
A copy of your responses will be emailed to the address you provided.
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