PicScience Math Academy — Community Seat Application

Priority Deadline: Friday, November 22
Awardee Notified by November 24

Thanks to Grove Community Outreach, one fully sponsored community seat is available for a motivated student needing extra math support. Don’t miss this opportunity—applications close on November 15.

Sign in to Google to save your progress. Learn more

Parent/Guardian Name
 *
First and last name
Parent/Guardian Email *
Parent/Guardian  Phone Number *

Student Name
 *
First and last name
Student Current Grade *
Required
School (or homeschool) *
CIty *
What challenges is your student facing in math right now? (1–3 short sentences)   *
What goals or improvements do you hope to see through this program? (confidence, grades, skills, etc.)   *

Has your student ever worked with a tutor before?
 *
If yes, what worked well or didn’t work well?
 *
Are you able to commit to twice-weekly live online sessions starting December 2?   *
Do you have a reliable device and internet connection for online learning?   *
Who will ensure your student joins each Zoom session on time? (Name + relationship)   *
Do you have reliable internet and a device for Zoom?
 *
Why would your student be a great fit for this sponsored opportunity? (Tell us about their potential, curiosity, or effort!)   *
Director/teacher/pastor who can confirm reliable attendance (Name + role)   *
Recommender Email or Phone #   *
  I agree to:   *
Required
Type your full name to confirm agreement   *
Preferred method of contact
 *
Required

Preferred time of day
 *
Required
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms