Student Intake Form: Summer 2022
This form is for those interested in joining Spanish class with me for the Summer or Fall of 2022.

Filling out this form doesn't mean you're committing to participating in class, but it will give you information about possible class times, prices, the Terms of Service, etc.

Thank you for considering me as you decide your family's Spanish teacher!

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Parent [or Adult Learner] Name
For current students: Do you plan to continue classes for the next semester? (If not, disregard the remainder of this form)
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Are you  [if an adult student]  OR Is your child comfortable reading?
Generally I communicate via email; but in case I need to get in touch with you more quickly: What is your preferred method of contact?
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Email address *
Phone number
Zoom is the platform used for the class. Do you already have a zoom account OR can you make one (for free)? *
Student Name(s), Age(s) [Ages: if under 18] *
Class Experience with Me *
Are you interested in your student(s) doing the class during the school year or year-round? *
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