Studio of Engaging Math
Registration Form 2016-2017. This form is to be filled by the parent/legal guardian of the student.
Student's first name
Your answer
Student's last name
Your answer
Gender
Date of birth
MM
/
DD
/
YYYY
School name
Your answer
Grade in school
Grade in our studio
What day is your child's lesson at the studio?
What time is the lesson?
If your child has not been assigned to the group yet, please leave this blank.
Time
:
What's the teacher's name?
Please tell us about your child’s learning strengths and weaknesses.
Your answer
Does your child experience any learning difficulties that might affect his/her performance or enjoyment of the Studio of Engaging Math? Is your child receiving any special education services in school? If so, please describe.
Your answer
Does your child have any medical conditions or illness (asthma, diabetes, etc.), any difficulties with hearing or vision, any allergies that we should be aware of?
Your answer
Is there any other information about your child that you would like us to know?
Your answer
Do you have other child (children) enrolled in the studio?
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